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Registered Nurse Utilization Review-Case Management job in San Antonio at Christus Health

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Registered Nurse Utilization Review-Case Management at Christus Health

Registered Nurse Utilization Review-Case Management

Christus Health San Antonio, TX Full-Time
CHRISTUS Santa Rosa Health System is about people. People we meet and care for; people whose lives we enhance, and those whose lives we save. CHRISTUS is about the people who work here: our award-winning medical staff, dedicated housekeeping staff, compassionate nurses and patient-focused ancillary staff. We're about people who need us, from small bumps to massive trauma, no matter their economic bracket. We're about the people of San Antonio, New Braunfels, and all the South Texas communities we serve. Since 1869, CHRISTUS Santa Rosa Health System has grown and flourished just as South Texas has grown. We remain the only Catholic faith-based, non-profit health care system in San Antonio and New Braunfels. Our healing ministry now includes five full-service hospitals with 1,159 licensed beds, and a number of specialty centers. If you are looking to join a rapidly growing faith-based organization that encourages professional development, we want you to become a part of the CHRISTUS Santa Rosa family Summary: The RN Utilization Review effectively communicates with internal and external clinical professionals, efficiently organizes the financial insurance care of the patients, and relays clinical data to insurance providers and vendors to obtain approved certification for services. They critically think for appropriateness of care provided to the patients and competently utilize approved screening criteria (InterQual/MCG/Centers for Medicare and Medicaid Services CMS Inpatient List). The RN Utilization Review Nurse collaborates as necessary with other members of the health care team to ensure the above according to the mission of CHRISTUS. Requirements: Associate's Degree in Nursing. Familiarity with criteria sets including InterQual and MCG preferred. A minimum of 2 years in acute clinical practice as a RN. Case management and Utilization Review experience preferred. RN License in state of employment or compact required. CPR certification preferred. Work Type: Full Time

Recommended Skills

  • Utilization Management
  • Managed Care
  • Credentialing
  • Medicare
  • Medical Management
  • Medicaid
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Job ID: AAFCAF61C037DB31B8C2F715FA6

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