Utilization Management RN – Day Shift, Outpatient Clinic

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

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.