Clinical Resource Utilization Specialist II

3 weeks ago


Tyler, Texas, United States Christus Health Full time

Job Summary:

We are seeking a highly skilled Clinical Resource Utilization Specialist II to join our team at Christus Health. This individual will play a vital role in evaluating the clinical appropriateness of patient care and ensuring efficient resource utilization within our healthcare settings.

Responsibilities:

  • Evaluate patient care plans to ensure they align with regulatory guidelines and optimize resource allocation
  • Conduct thorough reviews of medical necessity for patient admissions and coordinate care progression across the continuum
  • Collaborate with healthcare professionals to ensure effective communication and coordination of patient care
  • Analyze quality and comprehensiveness of documentation and work with physicians and treatment teams to obtain necessary information
  • Develop and implement strategies to improve patient outcomes and reduce healthcare costs
  • Stay up-to-date on regulatory requirements and industry trends to ensure compliance and optimal performance

Requirements:

  • Graduate of an accredited School of Nursing or demonstrated success in a similar role
  • At least two years of clinical experience, preferably in acute care settings
  • RN License in state of employment or compact required; LPN/LVN license accepted with 5+ years of experience
  • Certification in Case Management preferred; BLS preferred

Work Schedule:

7PM - 7AM, Full Time

Estimated Salary: $65,000 - $90,000 per year



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