Registered Nurse (RN) - Utilization Management

Matrix Providers Inc; Fairfield (CA); On-site; USD 140,000 - 165,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Life insurance

PTO

Paid Holidays

401(k) Plan

Job summary

Matrix Providers is hiring a Registered Nurse (RN) Utilization Management in Fairfield, CA. This full-time role focuses on coordinating case management, assessing patient needs, and ensuring high-quality care for service members and families.

The position requires an Associate's Degree in Nursing, active RN licensure, and 12 months of clinical case management experience. Compensation is hourly ($67.38) with a separate housing/wellness allowance, and a comprehensive benefits package including

Qualifications

• Associate's degree in nursing is required.
• ACEN/NLNAC/CCNE accredited program graduation required.
• Must hold RN licensure and relevant certifications in case management or equivalent.
• 12 months of recent full-time healthcare management experience.

Responsibilities

• Assess patient needs and coordinate case management.
• Educate patients and families about care plans.
• Advocate for patient and ensure timely, appropriate care.
• Coordinate with care teams and providers for effective outcomes.

Skills

Nursing

Case management

Client education

Education

Associate's Degree in Nursing

ACEN/NLNAC/CCNE accredited program

Tools

Microsoft Office

MS Outlook

Job description

Career Opportunities with Matrix Providers

Registered Nurse (RN) - Utilization Management

Matrix Providers is hiring a Registered Nurse (RN) Utilization Management to join our team of talented professionals who provide health care services to our Military Service Members and their families in Fairfield, CA.

• Employment Status: Full Time
• Compensation: This is an hourly position, paid bi-weekly.
  • $67.38/hour plus $5.42 H&W
• Schedule: Monday thru Friday 07:30 am - 4:30 pm
• Benefits: Competitive financial package with a comprehensive insurance package including health, dental, vision, and life coverage.
  • Accrued Paid Time Off (PTO)
  • Paid Holidays (Outlined in Handbook)
  • 401(k) Plan

Requirements: The Registered Nurse (RN)must have and meet the following:

• Degree: Associate's Degree in Nursing.
• Education: Graduate from a college or university accredited by Accreditation
  Commission for Education in Nursing (ACEN), National League for Nursing Accrediting
  Commission (NLNAC), the Commission on Collegiate Nursing Education (CCNE)
• Certifications in addition to Basic Life Support: Possess one of the following
  certifications: American Nurses Credentialing Center (ANCC), Nurse Case Manager
  (RN-NCM), National Academy of Certified Care Managers: Care Manager Certified
  (CMC) OR Commission for Case Manager Certification (CCMC): Certified Case
  Manager (CCM) or American Nurses Credentialing Center (ANCC) -OR- have practiced
  the equivalent of 2 years full-time as a registered nurse, and have a minimum of 2,000
  hours of clinical practice in nursing case management within the last 3 years, and have
  completed 30 hours of continuing education in nursing case management within the last 3
  years.
• Experience: Twelve (12) months of recent full-time experience in nursing/health care
  management for adults, children, families, seniors, or groups is required.
  • Possess a thorough clinical knowledge and breadth of experience to be able to contribute to population level assessment and management, identify appropriate Case Management candidates, conduct patient self-care education, and track patient outcomes.
  • Extensive knowledge of CM components: outcomes measurement, collaborative practice, patient self –management, population identification processes, and process improvement.
• Licensure: Current, full, active, and unrestricted license to practice as a Registered Nurse.
• Location - Travis AFB, David Grant Medical Center.

Job Summary:

• Must possess organization, problem-solving and communication skills to articulate
  medical requirements to patients, families/care givers, medical and nonmedical staff in a
  professional and courteous way.
• Must have the knowledge and skills to effectively apply the following core case
  management functions: a) Assessment: Identification of patients for case management;
  comprehensive collection of patient information and medical status; and continued
  evaluation of an established plan of care; b) Planning: Collaboration with the patient,
  family/caregiver, primary provider and other members of the health care team for
  developing an effective plan of care; c) Facilitation: Care coordination and
  communication among all involved parties; d) Advocacy: Support for the patient and
  family/caregivers to ensure identified education and appropriate, timely care is received.
• Must be skillful and tactful in communicating with people who may be physically or
  mentally ill, uncooperative, fearful, emotionally distraught, and occasionally dangerous.
• Must be knowledgeable in medical privacy and confidentiality (Health Insurance
  Portability and Accountability Act [HIPAA]); accreditation standards of Accreditation
  Association for Ambulatory Health Care (AAAHC) and The Joint Commission (TJC);
  and computer applications/software to include Microsoft Office programs, MS Outlook
  (e-mail), and internet familiarity is required.
• Identification of patients for case management; comprehensive collection of patient
  information and medical status; and continued evaluation of an established plan of care.
• Proactively implement CM services for populations with chronic conditions, collaborate
  with beneficiaries in formulating patient-centered goals, and educate individuals, their
  families or caregivers.
• Provide a warm handoff (person-to-person verbal communication providing continuity of
  care and a seamless transfer of information) of patients in transition to other levels or
  places of care by providing pertinent information to the receiving health care provider
  document warm handoff communications.
• Serves as patient advocate and liaison to healthcare and community agencies for matters
  concerning primary, secondary, and tertiary healthcare services. Actively participates as
  team member or facilitator of committee or working group.
• Attend multidisciplinary rounds, ward meetings/discharge planning meetings as required
  to ensure multidisciplinary collaboration and optimal effective communication.
• When possible ensure the patients families and care givers are involved in the case
  management process. Act as a point of contact when there are complex arrangements to
  be organized for patients.
• Completes and appropriately documents an assessment of patient, family and caregiver
  readiness, identifies individual health care needs, and proactively coordinates chronic
  condition care follow-on care.
• Be able to perform with minimal supervisory direction. Be able to independently identify,
  plan, and carry out projects with consideration for the goals and objectives of the MTF’s
  Utilization Management and Medical Management Departments.
• Assessment: Proactively identifies and evaluates patients and families for case
  management from a variety of sources such as discharge/disposition planning, referrals,
  the Medical Evaluation Board (MEB) process, the healthcare system, employers and
  facility staff. Conducts systematic, on-going, thorough collection of patient’s physical,
  emotional, psychological, social and medical status and information via direct patient
  contact and other relevant sources such as professional and non-professional caregivers,
  medical records, family/caregiver interviews.
• Planning: Develops an appropriate patient-specific plan of care to include short and long
  term goals, objectives and actions. Coordinates, collaborates, and obtains approval of the
  plan among the patient, family/caregiver, primary provider and other members of the
  healthcare team.
• Implementation: Guides the patient and family/care giver through the healthcare system, maximizing use of resources. Coordinates and executes the plan of care, optimizing access to appropriate services. Ensures necessary referrals are ordered by the appropriate discipline and coordinated. Serves as an advocate for, and ensures education is provided to, the patient and family/caregiver as required. Promotes adherence to treatment plans for improved healthcare outcomes.
• OTHER job duties to be provided with official Job Description

Matrix Providers will never request any form of payment from candidates in exchange for consideration for employment. Furthermore, all communication from Matrix Providers will be conducted exclusively through official Matrix Providers email addresses. Any correspondence from alternative email addresses should be considered fraudulent.

Matrix Providers endeavors to make www.matrixproviders.com accessible to all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please get in touch with our Recruiting Hotline Number, 1-877-807-8277, TTY LINE, 385-722-8109. This contact information is for accommodation requests only and cannot be used to inquire about the status of applications.