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Baylor Scott & White Health

Taylor, Texas

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Irving, Texas

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Tyler, Texas

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Boise, Idaho

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CHRISTUS Health

Irving, Texas

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Buda, Texas

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Duke University Health System

Durham, North Carolina

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Albuquerque, New Mexico

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Louisville, Kentucky

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MultiCare Health System

Yakima, Washington

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Las Vegas, Nevada

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Fredericksburg, Virginia

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Kindred Hospitals

Louisville, Kentucky

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Fredericksburg, Virginia

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Lakewood, Washington

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Baylor Scott & White Health

TEMPLE, Texas

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Kindred Hospitals

Houston, Texas

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Fairbanks, Alaska

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Fred Hutchinson Cancer Center

Seattle, Washington

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Bowling Green, Virginia

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Stafford, Virginia

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Fort Myers, Florida

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Orlando, Florida

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Mary Washington Healthcare

Fredericksburg, Virginia

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Utilization Management (RN) - Community Health Choice - Utilization Management
JOB SUMMARY: The UM RN will perform utilization review of Community members requiring authorization for health services. The UM RN will help ensure proper data entry of authorization in the managed care platform, and initiate the approval process for requested services/treatments utilizing nationally recognized evidenced based clinical criteria and/or internal policies, protocols, and procedures. The UM RN will screen and review clinical information for the most appropriate service areas within Community; making referrals to high risk perinatal team, complex case management and disease management. The UM RN will work closely with the Medical Directors and refer requests that do not meet medical necessity criteria. The UM


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