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American Academy of Pediatrics

Itasca, Illinois

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Oxford, Mississippi

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National Jewish Health

Denver, Colorado

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Toronto, Ontario, Canada

Institute of Health Policy, Management, and Evaluation

Toronto, Ontario, Canada

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CHRISTUS Health

Tyler, Texas

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Raleigh, North Carolina

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Kindred Hospitals

Denver, Colorado

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Raleigh, North Carolina

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Baylor Scott & White Health

Hewitt, Texas

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Cary, North Carolina

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Raleigh, North Carolina

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Saint Peters, Missouri

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New Providence, New Jersey

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Orange City, Florida

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AdventHealth

Shawnee Mission, Kansas

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Raleigh, North Carolina

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Util Mgmt (UM) Nurse-LVN (CHC)
Utilization Management (UM) nurses will assist in the management of CHC members in assessing authorization needs, proper data entry of authorization in the UM system, and assist with approval of requested services/treatments utilizing nationally recognized clinical criteria .They will handle incoming calls with regarding requests for authorizations or questions regarding the authorization process. They offer alternative and supplemental recommendations for services available in the community. Referral processing of requests for in patient care, Home Health Care, and durable medical equipment requests through coordination of CHC resources. They use their nursing knowledge and background to screen and review clinical informati


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