Utilization Management RN – Outpatient, Mon-Fri, No On-Call

SHR (Spectrum Healthcare Resources); Dallas County, TX; On-site; USD 85,000 - 105,000; Full time

Benefits offered by this job

Paid time off

Paid holidays

Medical insurance

Dental insurance

Vision insurance

401(k)

Job summary

Spectrum Healthcare Resources is seeking a Registered Nurse for Utilization Management at Lackland AFB in San Antonio, TX. The role supports a DoD medical management program in an outpatient clinic, with a Monday–Friday 7:30am–4:30pm schedule.

No nights, weekends, or on-call; PTO and holidays are offered; requires an Associate Degree of Nursing, RN licensure, and 2+ years of clinical UM experience, plus BLS certification.

Qualifications

• Associate Degree of Nursing required.
• Bachelor's degree in health sciences or health informatics from an accredited university.
• Active RN license in any state.
• 2+ years of clinical and utilization management RN experience.
• Basic Life Support Certification from American Heart.

Responsibilities

• Supports a comprehensive MTF Utilization Management plan/program per DoD guidance.
• Actively and retrospectively reviews medical cases to confirm appropriate care and identify improvements.
• Reports on utilization patterns and briefs staff and leadership.
• Maintains reports on denials and payments and communicates findings to management.
• Participates on multi-disciplinary teams to resolve problems in healthcare delivery.
• Research and analyze queries from MTF clinics using data reports.
• Provide education and guidance on reporting systems to clinic staff.

Skills

RN Utilization Management

Clinical UM experience

Active RN license

Basic Life Support

Strong medical documentation

Education

Bachelor's degree in health sciences or health informatics

ACEN/CCNE accredited program graduate

Job description

Spectrum Healthcare Resources is seeking a Registered Nurse for Utilization Management at Lackland AFB in San Antonio, TX. The role supports a DoD medical management program in an outpatient clinic, with a Monday–Friday 7:30am–4:30pm schedule.

No nights, weekends, or on-call; PTO and holidays are offered; requires an Associate Degree of Nursing, RN licensure, and 2+ years of clinical UM experience, plus BLS certification.