Registered Nurse (RN) - Utilization Management

SHR (Spectrum Healthcare Resources); Town of Texas (WI); On-site; USD 85,000 - 105,000; Full time

Benefits offered by this job

Paid time off

Paid holidays

Medical insurance

Dental insurance

Vision insurance

401(k)

Job summary

Spectrum Healthcare Resources is seeking a Registered Nurse for Utilization Management at Lackland AFB in San Antonio, TX. The role supports a DoD medical management program in an outpatient clinic, with a Monday–Friday 7:30am–4:30pm schedule.

No nights, weekends, or on-call; PTO and holidays are offered; requires an Associate Degree of Nursing, RN licensure, and 2+ years of clinical UM experience, plus BLS certification.

Qualifications

• Associate Degree of Nursing required.
• Bachelor's degree in health sciences or health informatics from an accredited university.
• Active RN license in any state.
• 2+ years of clinical and utilization management RN experience.
• Basic Life Support Certification from American Heart.

Responsibilities

• Supports a comprehensive MTF Utilization Management plan/program per DoD guidance.
• Actively and retrospectively reviews medical cases to confirm appropriate care and identify improvements.
• Reports on utilization patterns and briefs staff and leadership.
• Maintains reports on denials and payments and communicates findings to management.
• Participates on multi-disciplinary teams to resolve problems in healthcare delivery.
• Research and analyze queries from MTF clinics using data reports.
• Provide education and guidance on reporting systems to clinic staff.

Skills

RN Utilization Management

Clinical UM experience

Active RN license

Basic Life Support

Strong medical documentation

Education

Bachelor's degree in health sciences or health informatics

ACEN/CCNE accredited program graduate

Job description

Job Description

Spectrum Healthcare Resources has a potential opportunity for a

• Monday-Friday 730am-430pm
• No On-Call
• Paid time off and paid holidays
• Benefits package including Medical, Dental, Vision and 401(k) and more…

Registered Nurse Utilization Management at Lackland AFB in San Antonio, TX.

• 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…

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

Location

US-TX-