Utilization Management Nurse - Case Management

CHRISTUS Santa Rosa Hospital - Westover Hills (CSRH-WH) is a 253-bed hospital serving the fastest-growing area of San Antonio. Specialized care includes orthopedic and surgical care with advanced spine surgery, Intensive Care, complex neurology for treating stroke and other neurovascular issues, comprehensive cardiovascular care from diagnostics to open heart surgery, vascular lab, sleep center, women's services, a newborn nursery, the CHRISTUS Weight Loss Institute, wound care, rehabilitation, emergency services, and more. The Utilization Management Nurse PRN 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).