Utilization Management Registered Nurse - Remote - Arizona

Naphcare, Inc.; Phoenix (AZ); A distancia; USD 85.000 - 105.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health, dental & vision insurance

401K and Roth with company match

Tuition Assistance

Paid time off

Continuing education/CMEs

Descripción de la vacante

NaphCare is hiring an experienced Utilization Management Registered Nurse for a Remote role based with an Arizona team. The RN will oversee quality assurance, utilization review, and clinical chart assessments while collaborating with physicians to determine medical necessity.

Applicants should hold an Arizona RN license with a BSN or ADN, have 3+ years in acute care and 2 years in utilization review, and possess CPR certification. Some travel may be required, and benefits are comprehensive.

Formación

• Current and unrestricted RN license in Arizona
• Minimum 3 years’ acute care experience and 2 years in utilization review/case management
• CPR certification

Responsabilidades

• Develop, implement, and administer quality assurance and utilization review processes
• Monitor and report on the quality of medical care
• Perform utilization and concurrent review of patient cases
• Conduct clinical chart assessments
• Gather information to assess and expedite care needs
• Determine need for intervention and discuss with physicians
• Review medical necessity of services and refer to Medical Director as needed
• Audit medical records to determine medical necessity
• Apply nationally recognized criteria to determine medical necessity

Conocimientos

Communication skills

Interpersonal skills

Attention to detail

Decision making

Educación

BSN/ADN

Descripción del empleo

Overview

NaphCare is hiring an experiencedUtilization Management Registered Nursejust like you to join our Remote based, Arizona team.

NaphCare is a family owned, healthcare technology company that has been delivering high quality healthcare to correctional facilities across the nation for over 35 years. Come join our team of over 5000 employees and growing!NaphCare pays well, offers outstanding benefits, and has an incredibly engaged corporate support team to make sure you have what you need to be truly excellent at what you do.

NaphCare partners with correctional facilities to provide proactive, patient-focused healthcare.

NaphCare has a partnership with NetCE that provides CEU/CME for our staff. NetCE uses a rigorous peer review process to ensure that all activities and content are up-to-date. This service streamlines continuing education for all NaphCare Employees to meet state specific requirements for maintaining licensing.

With NaphCare, you'll play a critical role in our continuing mission to be the leading provider of quality healthcare in the correctional industry. If you want a career that will make a difference, choose the company that is different.

We support your growth and internal promotion. Once hired, we encourage our employees to continue to seek opportunities for advancement and leadership.

Responsibilities

• Develop, implement, and administer the quality assurance and utilization review processes
• Monitor and report on the quality of all facets of the medical care provided to patients
• Perform utilization and concurrent review of patient cases
• Conduct detailed clinical chart assessments
• Gather clinical information to assess and expedite care needs
• Determine need, if any, for intervention, and discussing with physicians
• Reviews requests from providers regarding medical necessity of requested services for patients
• Reviews and audits patients' medical records as indicated to determine medical necessity
• Utilizes nationally recognized criteria to determine medical necessity of requested services
• Refers provider requests to Medical Director or designee when medical necessity of requested services does not meet recognized criteria

Qualifications

• A current and unrestricted RN license in Arizona
• A minimum of 3 years’ experience in an acute care setting and 2 years’ experience in utilization review and/or case management
• Valid cpr card
• Excellent communication and interpersonal skills
• attention to detail and decision-making skills are essential
• BSN or ADN required.
• Some travel required.

Physical Capabilities:

Must have the ability to stand for long periods, lift and move patients (up to 50 pounds), bend, squat, reach, push, pull, walk significant distances, and perform physically demanding tasks like CPR, all while maintaining good balance and endurance throughout a shift.

Why Join NaphCare?

NaphCare is one of the largest providers of healthcare services to correctional facilities throughout the US and we are growing. If you have never considered a career in correctional healthcare, now may be the time. In addition to competitive salaries and generous employee benefits, we strongly support career advancement within the company.

NaphCare Benefits for Full-Time Employees Include:

• Health, dental & vision insurance that starts day one!
• Prescriptions free of charge through our health plan, beginning day one!
• Lowest Cost Benefits!
• Employee Assistance Program (EAP) services
• 401K and Roth with company contribution that starts day one!
• Tuition Assistance
• Referral bonuses
• Term life insurance at no cost to the employee
• Generous paid time off & paid holidays
• Free continuing education and CMEs

Equal Opportunity Employer: disability/veteran

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