Registered Nurse Utilization Review Lead - Psychiatric Admin
Alamogordo, New Mexico
RN
Posted Sep 6
- Shift
- 8-hour days
- Unit
- Psychiatric Admin
What the listing says
Role
- Schedule
- 8AM - 5PM Monday-Friday
- Weekends
- No weekends
- Term
- Permanent
- Setting
- Clinic
- Accepts
- RN
- Experience
- 3+ years
More role details
- Unit
- Psychiatric Admin
Ratio not posted. Ask in the interview.
Pay
We don’t have a pay range for this role yet.
We can help you find the number.
About this role
Summary
The Registered Nurse Utilization Review Lead will be the initial point of contact for the health plans utilization management team regarding any questions, issues, or concerns. The RN Utilization Review Lead effectively communicates with internal and external clinical professionals, efficiently organizes the financial insurance care of the patients, and relays clinical data to insurance providers and vendors to obtain approved certification for services. They critically think for appropriateness of care provided to the patients and competently utilize approved screening criteria.
The RN Utilization Review Lead is responsible for hands-on leadership of the Utilization Management Nursing Team to contain medical costs, oversee the utilization of health services and treatments, and ensuring the UM team meets designated quality metrics. The Lead serves as a clinical resource to the utilization management team, members, and outside medical providers.
Read the full posting
Responsibilities
- Frequently communicates complex information and interacts through electronic documentation tools.
- Oversees the provision of Utilization Management functions which include Pre-Certification, Concurrent Review, as well as Discharge Planning for Admissions and Outpatient Services.
- Continuously evaluates workflow issues while seeking to improve processes that impact the Department.
- Supervises, analyzes and coordinates the daily activities of the work queue to ensure that departmental productivity goals are met with regards to quality, timeliness, accuracy and consistency of medical decisions. Drives performance of teams while promoting inter-rater reliability.
- Recommends and implements department policies and procedures, and interfaces with other areas to ensure consistent applications.
- Develops and monitors goals for staff as well as provides ongoing feedback and coaching.
- Conducts performance reviews on an annual basis, coaches for performance, and leads by example.
- Supervises the daily operational duties of a care team. Ensures an atmosphere within the team, which fosters open communication, teamwork, ownership and empowerment to make decisions.
- Other duties as assigned
Requirements
Education/Skills
- Bachelor of Nursing
Experience
- 3 years or more in a lead nursing role
Licenses, Registrations, or Certifications
- RN License in state of employment or compact required
- CPR certification preferred
- Certification in Case Management preferred
Work
Schedule
8AM - 5PM Monday-Friday
Work Type
Full Time
Sourced from a public job board.
Requirements
- Bachelor of Nursing
- 3 years or more in a lead nursing role
Place
- City
- Alamogordo, New Mexico
- Median rent
- $902/mo
- Local household income
- $55,952/yr
- State price level
- 8% below the national average
- Address
- 2669 N Scenic Dr, Alamogordo, NM 88310, USA
rent and tenant-paid utilities
all local households, not nurse pay
New Mexico index 92.2, where 100 is the national average.
Tucked in the Tularosa Basin with the Sacramento Mountains rising to the east, Alamogordo pairs high-desert living with small-town ease. Nearby White Sands National Park offers otherworldly dunes for off-duty exploring, while Holloman Air Force Base anchors the local economy. Mild winters and abundant sunshine define this southern New Mexico community.
Cost figures from U.S. Bureau of Economic Analysis.
How this role fits you
Add your preferences
Choose your specialty, travel preference, and license stage to see how this role fits.
The work you want
Where you'd go
Where you are
About the employer
CHRISTUS Health is a faith-based, not-for-profit Catholic health system with operations in San Antonio, TX, and globally. Led by President and CEO Ernie Sadau, the system has earned the prestigious 'Great Place to Work' national certification in consecutive years, with…
On your path
Psychiatric is open from year one. Behavioral health spans inpatient, emergency, and community settings.
Worth asking
The posting doesn’t answer these. Good ones to ask a recruiter or in the interview.
- Can you walk me through base pay range and differentials?
- What should I expect for weekend, holiday, call, and rotation?
- What orientation, preceptor time, and ongoing unit support are included?
- How are patient load, floating, and staffing support handled day to day?