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Shannon Health

San Angelo, Texas

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CommonSpirit Health Mountain Region

West Jordan, Utah

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Demorest, Georgia

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Baylor Scott & White Health

Anderson Mill, Texas

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Los Angeles, California

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Westminster, Colorado

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Georgetown, Texas

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Apex, North Carolina

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Olympia, Washington

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Indianapolis, Indiana

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Nashville, Tennessee

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Cleveland, Mississippi

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Demorest, Georgia

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Cedar Park, Texas

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Nashville, Tennessee

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CommonSpirit Health Mountain Region

Westminster, Colorado

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Houston, Texas

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PIH Health

Whittier, California

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Colorado Springs, Colorado

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Spartanburg, South Carolina

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Colorado Springs, Colorado

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Jollyville, Texas

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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 policys, 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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