Utilization Management Nurse II

2 months ago


Tyler, Texas, United States Christus Health Full time
Job Summary

The Utilization Management Nurse II is a critical role at Christus Health, responsible for ensuring the clinical appropriateness of care provided to patients and optimizing hospital resource utilization. This position requires a skilled nurse with expertise in clinical decision-making, case management, and healthcare policy.

Key Responsibilities
  • Conduct comprehensive assessments of patient information and treatment plans to determine medical necessity and level of care.
  • Apply clinical judgment and expertise to make informed decisions regarding patient care and resource utilization.
  • Collaborate with interdisciplinary teams to ensure seamless patient care and optimize resource allocation.
  • Develop and maintain knowledge of regulatory requirements, healthcare policies, and clinical guidelines to ensure compliance and best practices.
  • Communicate effectively with patients, families, and healthcare professionals to ensure informed decision-making and optimal patient outcomes.
  • Participate in quality improvement initiatives to enhance patient care and reduce healthcare costs.
Requirements
  • Graduate of an accredited School of Nursing or demonstrated success in a Utilization Management Nurse I role.
  • Two or more years of clinical experience, with at least one year in an acute care setting.
  • RN License in the state of employment or compact required.
  • Certification in Case Management preferred.
Work Schedule

8AM - 5PM, Monday - Friday

Work Type

Full Time



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