Utilization Management RN

VitalCore Health Strategies; Hopkinton (MA); On-site; USD 100,000 - 110,000; Full time

Benefits offered by this job

Holiday Pay

Life Insurance

Short-Term/Long-Term Disability

Employee Assistance Program

401(k)

Job summary

A leading correctional healthcare provider is seeking a Utilization Management RN to serve as a Regional Office Case Manager. Responsibilities include advocating for optimum healthcare for an incarcerated population, maintaining records, and coordinating patient care plans. Applicants should have a Registered Nurse Licensure and at least one year of experience. This full-time position offers a competitive salary range of $100,000–$110,000 annually and includes comprehensive benefits.

Qualifications

• Graduated from an accredited School of Nursing.
• Licensure as a Registered Nurse with 1+ years of experience.
• Active CPR certification.

Responsibilities

• Serve as a Regional Office Case Manager for an incarcerated population.
• Maintain accurate, detailed reports and confidential records.
• Consult and coordinate with healthcare team members.

Skills

Case Management

Patient Care Coordination

Clinical Documentation

Communication Skills

Education

Registered Nurse Licensure

Job description

Join to apply for the Utilization Management RN role at VitalCore Health Strategies.

VitalCore Health Strategies (VCHS), an industry leader in Correctional Healthcare, has a Full-Time opening for a Utilization Management RN at the Regional Office in Hopkinton, MA.

Start A New Career with VitalCore Health Strategies!

At VitalCore we pride ourselves on retaining and acquiring hardworking ethical individuals who are committed to providing quality services. Join our team and experience first‑hand how VitalCore Health Strategies promotes a positive work environment that is based on respect and appreciation of the hard work and dedication of our staff.

Essential Functions

• Serve as a Regional Office Case Manager for an incarcerated population, advocating for optimum healthcare.
• Maintain accurate, detailed reports and confidential records.
• Consult and coordinate with healthcare team members to assess, plan, implement, or evaluate patient care plans.
• Modify patient treatment plans as indicated by patients’ responses and conditions.
• Review all aspects of facility patient care.
• Review referrals for offsite treatment and care for appropriateness and best utilization of resources.
• Act as a liaison with all offsite providers, both specialty as well as hospitals.
• Review medical transports to Emergency Departments to ensure continuity of care.
• Oversee hospitalized cases, including reviewing daily clinicals and providing information to facility MD and team.
• Assist with hospital discharge planning to ensure goals of care are met.
• Seek infirmary‑level bed placement when care is needed on a higher level.
• Additional duties as assigned by regional office.

Minimum Requirements / Preferences

• Graduate of an accredited School of Nursing.
• Licensure as a Registered Nurse in the state of employment with 1+ years of experience, or as an LPN with 5+ years of experience.
• Preferred experience in Med‑Surg, Case Management, and/or Discharge Planning.
• Possesses an active CPR certification.
• Remains knowledgeable about specific state laws and regulations governing practice.
• Satisfactory completion of initial and annual clinical competencies to demonstrate aptitude as assigned by the role.

Benefits

Holiday Pay: New Year’s Day, Martin Luther King Jr. Day, Memorial Day, Juneteenth, Independence Day, Labor Day, Veteran’s Day, Thanksgiving Day, and Christmas Day.

• Life Insurance
• Short‑Term/Long‑Term Disability
• Identity Theft Protection
• Animal/Pet Insurance
• Employee Assistance Program and Discount Center
• 401(k)
• EEO

Compensation Details: $100,000–$110,000 Yearly Salary.

Seniority Level

Mid‑Senior Level

Employment Type

Full‑time

Job Function

Health Care Provider

EEO Statement: The company is an equal opportunity employer and provides equal employment opportunities to all employees and applicants without discrimination.