RN UTILIZATION MANAGERS NEEDED IN DALLAS/FORT WORTH!!

Performs technical and administrative work required to evaluate the necessity, appropriateness and efficiency of the use of medical services procedures and facilities. Licensed RN responsible for clinical review of all acute and subacute services for appropriateness based on medical criteria. This individual is responsible for the management of healthcare resources necessary and appropriate for achievement of desired acute and subacute outcomes and the coordination of alternative levels of care for membership.
REQUIREMENTS
EDUCATION AND EXPERIENCE:
• Currently licensed RN with three years experience in health care, case management, discharge planning, utilization management, or behavioral health.
• Two years of Utilization Management or Hospital/Acute care experience required.
• Experience working on the community level and with community agencies preferred.

Certification and Licensure:
• Current State RN license
• Certified Professional Utilization Review (as required by Plan)
• Certified Case Managers a plus.
• Must possess a valid driver’s license and access to a motor vehicle.

Principle Accountabilities:
• Computer literate.
• Excellent verbal and written communications skills.
• Strong decision making skills.
• Ability to provide services in an environment that involves multiple health care systems.
• Ability to interact with all relevant components of the health care system.
• Ability to provide services that deal with the individual’s broad spectrum of needs.
• Self-starter with ability to handle multiple projects at one time.
• Appreciation of cultural diversity and sensitivity towards target population.
• Bilingual a plus.