RN Case Manager/Utilization Review

Responsibilities

We are seeking a PRN Case Manager for weekend shifts to evaluate the appropriateness and efficiency of healthcare services. Responsibilities include:

• Reviewing medical records to assess admission criteria.
• Ensuring patients receive appropriate care based on clinical guidelines.
• Performing pre-authorization and ongoing reviews for medical treatments.
• Collaborating with healthcare providers for care alignment.
• Coordinating transitions of care with patients and families.
• Monitoring hospital admissions, extended stays, and discharges.
  
  

Requirements include a nursing degree, Texas RN license, current BLS certification, and three years of nursing or social work experience. Strong communication and educational skills are essential.