Registered Nurse (RN) - Utilization Management

Job Description

Spectrum Healthcare Resources has a potential opportunity for a Registered Nurse Utilization Management at Lackland AFB in San Antonio, TX.

This contract position offers:

• Monday-Friday 730am-430pm


• Outpatient Clinic


• No Nights, Weekend or Holidays


• No On-Call


• Stable Patient Population


• Paid time off and paid holidays


• Benefits package including Medical, Dental, Vision and 401(k) and more…

Requirements:

• Associate Degree of Nursing. Must possess a bachelor's degree in relevant health sciences or health informatics from an accredited university.


• Graduate from a college or university accredited by the ACEN or CCNE


• Active RN license in any state


• 2+ years of clinical and utilization management RN experience


• Basic Life Support Certification from American Heart

Core Duties:

• Supports a comprehensive MTF Utilization Management plan/program as prescribed in the DoD Medical Management Guide and by the MTF Utilization Management Director.


• Actively and retrospectively reviews medical cases to confirm receipt of appropriate care, monitor for patterns/trends and develop action plan for areas requiring improvement.


• Reports on utilization patterns; briefs provider staff and executive staff.


• Maintains reports on which cases have been denied or received reduced third party payments and reports provider profiles to the MTF management for corrective action.


• Participates on multi-disciplinary teams to resolve recurring problems in the healthcare delivery process for care within or outside the MTF including referrals


• Research and Analysis: Investigate and resolve queries from MTF clinics by analyzing reports and data.


• Education and Training: Provide education and guidance on reporting systems and tools to ensure effective utilization by clinic staff.

For More Information Contact:

Melissa Powell

Company Overview:

Spectrum Healthcare Resources (SHR) was established in 1988 to deliver systems and processes designed to meet the unique needs of Militaryand VA Health Systems. SHR is a leading organization that provides physician and clinical staffing and management services to United States Military Treatment Facilities, VA clinicsand other Federal Agencies through various contracting vehicles. A Joint Commission Health Care Staffing Services firm, SHR isthe military staffing division of TeamHealth, a Nationwide organization that serves 850 civilian and military hospitals with a team of 9,600 affiliated health care professionals. EOE/Disabled/Veterans