Registered Nurse (RN) - Utilization Management

Spectrum Healthcare Resources; San Antonio (TX); On-site; USD 80,000 - 105,000; Full time

Benefits offered by this job

Paid time off

Paid holidays

Medical benefits

Dental benefits

Vision benefits

401(k)

Job summary

Spectrum Healthcare Resources is seeking a Registered Nurse for Utilization Management at Lackland AFB in San Antonio, TX. This contract position offers a Monday-Friday schedule from 7:30am to 4:30pm in an outpatient clinic with no nights, weekends, or on-call requirements.

The role requires an Associate Degree in Nursing with a Bachelor's degree in health sciences or health informatics, ACEN/CCNE accreditation, and an active RN license.

Qualifications

• Active RN license in any state.
• 2+ years of clinical and utilization management RN experience.
• Basic Life Support Certification from American Heart Association.

Responsibilities

• Support a comprehensive MTF Utilization Management plan/program per DoD guidelines.
• Actively and retrospectively review cases to ensure appropriate care.
• Monitor utilization patterns and develop action plans for improvement.
• Report on utilization patterns and brief provider and executive staff.
• Maintain reports on denied or reduced payments and share findings with management.
• Collaborate on multi-disciplinary teams to resolve care-delivery issues.

Skills

RN license

BLS Certification

Utilization Management experience

Education

Associate Degree of Nursing

Bachelor's degree in health sciences or health informatics

ACEN/CCNE accreditation

Job description

Registered Nurse (RN) - Utilization Management

Job Description

Spectrum Healthcare Resources has a potential opportunity for a Registered Nurse Utilization Management at Lackland AFB in San Antonio, TX.

This contract position offers:

• Monday-Friday 730am-430pm
• Outpatient Clinic
• No Nights, Weekend or Holidays
• No On-Call
• Stable Patient Population
• Paid time off and paid holidays
• Benefits package including Medical, Dental, Vision and 401(k) and more...

Requirements:

• Associate Degree of Nursing. Must possess a bachelor's degree in relevant health sciences or health informatics from an accredited university.
• Graduate from a college or university accredited by the ACEN or CCNE
• Active RN license in any state
• 2+ years of clinical and utilization management RN experience
• Basic Life Support Certification from American Heart

Core Duties:

• Supports a comprehensive MTF Utilization Management plan/program as prescribed in the DoD Medical Management Guide and by the MTF Utilization Management Director.
• Actively and retrospectively reviews medical cases to confirm receipt of appropriate care, monitor for patterns/trends and develop action plan for areas requiring improvement.
• Reports on utilization patterns; briefs provider staff and executive staff.
• Maintains reports on which cases have been denied or received reduced third party payments and reports provider profiles to the MTF management for corrective action.
• Participates on multi-disciplinary teams to resolve recurring problems in the healthcare delivery process for care within or outside the MTF including referrals
• Research and Analysis: Investigate and resolve queries from MTF clinics by analyzing reports and data.
• Education and Training: Provide education and guidance on reporting systems and tools to ensure effective utilization by clinic staff.

For More Information Contact

Melissa Powell

719-528-7965

[e-mail]

Company Overview

Spectrum Healthcare Resources (SHR) was established in 1988 to deliver systems and processes designed to meet the unique needs of Military and VA Health Systems. SHR is a leading organization that provides physician and clinical staffing and management services to United States Military Treatment Facilities, VA clinics and other Federal Agencies through various contracting vehicles. A Joint Commission Health Care Staffing Services firm, SHR is the military staffing division of TeamHealth, a Nationwide organization that serves 850 civilian and military hospitals with a team of 9,600 affiliated health care professionals.

EOE/Disabled/Veterans