Utilization Management Nurse II - Case Management - Full Time in Longview, TX for CHRISTUS Health

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Care Manager II - Case Management

CHRISTUS Health

Corpus Christi, Texas

Utilization Management Nurse II - Case Management - Full Time

DescriptionSummary:The Utilization Management Nurse II is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services. This Nurse is responsible for performing a variety of pre-admission, concurrent, and retrospective UM related reviews and functions. They must competently and accurately utilize approved screening criteria (InterQual/MCG/Centers for Medicare and Medicaid Services "CMS" Inpatient List). They effectively and efficiently manage a diverse workload in a fast-paced, rapidly changing regulatory environment and are responsible for maintaining current and accurate knowledge regarding commercial and government payors and Joint Commission regulations and guide

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