RN Utilization Management & Care Coordination

ADP, Inc.; Virginia (MN); On-site; USD 66,000 - 73,000; Full time

Job summary

Professional Performance Development Group (PPDG) seeks a Registered Nurse - Utilization Management to support Langley Air Force Base operations. The RN reviews medical necessity, coordinates care with the care team, and supports case management to promote quality outcomes for military beneficiaries.

The role emphasizes utilization management, care coordination, and adherence to DHA, DoD, and facility requirements.

Qualifications

• RN with minimum 1 year nursing experience after graduation.
• Active RN license in the United States.
• Knowledge of utilization management and case management.

Responsibilities

• Perform utilization management reviews for medical necessity.
• Coordinate patient care with physicians, nurses, and case managers.
• Review admissions, referrals, procedures and treatment plans.
• Assist discharge planning and continuity-of-care activities.
• Maintain accurate documentation and protect patient confidentiality.

Skills

Utilization management

Case management

Nursing

Clinical assessment

Communication

Education

Associate Degree in Nursing

Tools

Electronic health records (EHR)

EMR systems

Job description

Professional Performance Development Group (PPDG) seeks a Registered Nurse - Utilization Management to support Langley Air Force Base operations. The RN reviews medical necessity, coordinates care with the care team, and supports case management to promote quality outcomes for military beneficiaries.

The role emphasizes utilization management, care coordination, and adherence to DHA, DoD, and facility requirements.