Utilization Review Specialist

Memorial Hermann

Clinical appropriateness review
Utilization management software
Patient care coordination
At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community

Job Summary

  • At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community.
  • The role involves using approved clinical appropriateness criteria to monitor admissions and continued stays, coordinating patient care progression, and collaborating with physicians and payors to ensure timely and appropriate patient management.
  • The position promotes professional growth by supporting continuing education and serving as a mentor, while modeling Memorial Hermann’s service standards to provide safe, caring, personalized, and efficient experiences.

Matching Summary

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community.

Skills & Requirements

Must-have

  • clinical appropriateness review
  • utilization management software
  • patient care coordination
  • medical necessity documentation
  • communication with multidisciplinary team
  • discharge planning activities

Nice-to-have

  • conflict resolution skills
  • clinical performance improvement
  • mentoring and precepting staff
  • compassionate patient experience

Key Requirements

  • Graduate of accredited nursing school
  • Current unrestricted RN license in Texas
  • Two years clinical or utilization review experience

Work Rights

Current, unrestricted RN license in Texas required

Tailored Resume

Cover Letter