The University of Texas Medical Branch Utilization Review Case Manager - Galv. Campus Utilization Mgt (Galveston) in Galveston, Texas

Min Qualifications

REQUIRED EDUCATION / EXPERIENCE:

Graduation from an accredited school of professional nursing and current Texas Nursing licensure as a professional registered nurse. Minimum of three years of full time wage earning experience as a professional nurse in a health care setting.

Job Description:

Performs technical and administrative work required to evaluate the necessity, appropriateness, and efficiency of the use of medical services, procedures, and facilities. Supports the UTMB Utilization Management Program utilizing clinical knowledge, expertise, and criteria guidelines.

Salary Range **

The salary range for this position is $62,720/yr - $94,080/yr commensurate with experience

The pay band for this position is NS22

Specific Job Related Duties **

In this role, you will perform technical and administrative work required to evaluate the necessity, appropriateness, and efficiency of the use of medical services, procedures, and facilities. Supports the UTMB Utilization Management Program utilizing clinical knowledge, expertise, and criteria guidelines. Helping to improve clinical* decision-making* and care management across the medical and behavioral health continuums of care.

Our Ideal Candidate will have:

  • Experience with Interqual and/or MCG
  • Knowledge of Medicare/Medicaid guidelines
  • Advanced communication skills:
  • Physicians
  • Payers
  • Ancillary departments

Work Schedule **

Varied shifts of 8 hours + 1-2 weekends /month

Preferred Education **

BSN or higher

Closing Statement **

#top #nurse

Equal Employment Opportunity **

UTMB Health strives to provide equal opportunity employment without regard to race, color, national origin, sex, age, religion, disability, sexual orientation, gender identity or expression, genetic information or veteran status. As a VEVRAA Federal Contractor, UTMB Health takes affirmative action to hire and advance women, minorities, protected veterans and individuals with disabilities.

Full/Part Time: Full-Time

Job Type: Regular

Job Title: Utilization Review Case Manager - Galv. Campus Utilization Mgt (Galveston)

Job ID: 59992

Location: Galveston

Business Unit: HOSPT