Clinical Resource Manager

7 days ago


Tyler, Texas, United States CHRISTUS Health Full time
Job Overview:
Innovative healthcare organization CHRISTUS Health seeks a skilled Clinical Resource Manager to lead utilization and care coordination efforts. This key role will drive optimal patient outcomes, enhance operational efficiency, and foster strategic partnerships within the healthcare ecosystem.

Responsibilities:
  • Evaluate clinical information, treatment plans, and medical necessity criteria to determine appropriate levels of care.
  • Analyze data to identify potential problems, formulate goals, and drive performance improvement initiatives.
  • Maintain current knowledge of regulatory requirements, insurance policies, and best practices in utilization management and care coordination.
  • Collaborate with interdisciplinary teams, physicians, payors, and patients to ensure seamless transitions, minimize unnecessary hospitalizations, and optimize resource allocation.
  • Develop and implement effective care coordination strategies to reduce readmissions, length of stay, and costs.
  • Ensure compliance with accreditation standards, regulatory guidelines, and organizational policies.
  • Monitor and report on key performance indicators (KPIs) related to utilization management, care coordination, and patient outcomes.
  • Foster strong relationships with stakeholders, including providers, payors, and community resources, to facilitate smooth transitions and optimize patient care.

Requirements:
  • Demonstrated expertise in utilization management, care coordination, or a related field.
  • Minimum 2 years of experience in a clinical setting, preferably in acute care or case management.
  • RN license in the state of employment or compact required; LPN/LVN license accepted for associates with 5+ years of demonstrated success.
  • Certification in Case Management or a related field preferred.
  • BLS certification preferred.

Work Schedule:7PM - 7AM
Work Type:Full Time

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