Utilization Management RN – Day Shift, Outpatient Clinic

Spectrum Healthcare Resources

San Antonio (TX)

On-site

USD 80,000 - 105,000

Full time

14 days+

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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

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.

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