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Registered Nurse Utilization Review Full Time Days in El Paso, TX for THOP Market Shared Services
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Registered Nurse Utilization Review Full Time Days
Summary The Registered Nurse is responsible to facilitate effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient�s resources and right to self-determination. The Registered Nurse has overall responsibility for ensuring that care is provided at the appropriate level of care based on medical necessity. The Registered Nurse manages medical necessity process for accurate and timely payment for services which may require negotiation with a payer on a case-by-case basis. The Registered Nurse integrates national standards for case management scope of services including: Utilization Management services supporting medical necessity and denial


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Case Management Society of America
5034A Thoroughbred Lane
Brentwood, TN 37027