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Northeast Georgia Health System

Demorest, Georgia

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UCLA

Los Angeles, California

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BJC HealthCare

Saint Louis, Missouri

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North Kansas City Hospital

North Kansas City, Missouri

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Providence

Portland, Oregon

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BJC HealthCare

Belleville, Illinois

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University of Maryland Medical System

Bel Air, Maryland

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BJC HealthCare

Sullivan, Missouri

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University of Maryland Medical System

Bel Air, Maryland

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Pediatrix Medical Group

Wichita Falls, TX, USA

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BJC HealthCare

Shiloh, Illinois

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University of Maryland Medical System

Bel Air, Maryland

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CHRISTUS Health

Tyler, Texas

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WakeMed Health & Hospitals

Raleigh, North Carolina

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University of Maryland Medical System

Bel Air, Maryland

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Baylor Scott & White Health

Rowlett, Texas

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Pediatrix Medical Group

Richmond, VA, USA

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BJC HealthCare

Belleville, Illinois

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AdventHealth

Orlando, Florida

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Baylor Scott & White Health

Rockwall, Texas

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Baylor Scott & White Health

Wylie, Texas

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UNC Health

Chapel Hill, North Carolina

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University of Maryland Medical System

Bel Air, Maryland

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AdventHealth

Tampa, Florida

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Util Mgmt (UM) Nurse RN
JOB SUMMARYThe 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 policy?s, 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


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