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Utilization Manager - Registered Nurse

73% Flex
Remote: 
Full Remote
Contract: 
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Offer summary

Qualifications:

BSc in Nursing, 6 years clinical nursing experience, 1 year Utilization Management experience.

Key responsabilities:

  • Coordinate care for military members' families
  • Conduct Utilization Management functions: Assessment, Planning, Facilitation, Advocacy
  • Track ER/UC utilization, coordinate referrals, ensure care criteria
Spectrum Healthcare Resources logo
Spectrum Healthcare Resources Large http://www.spectrumhealth.com/
1001 - 5000 Employees
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Job description

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Job Description:

CANNON AFB Banner

 

Spectrum Healthcare Resources is seeking a civilian, Registered Nurse (RN) to work as a Utilization Manager for our client at the Cannon Air Force Base. 

 

The Utilization Manager will be responsible for coordination of care for active-military members and their families/dependents.

    • This is a Monday-Friday position with no required overtime. 
    • Hours: 8 hour shifts between 0730-1630 (7:30AM - 4:30PM)  1HOUR Lunch

Description/Job Duties:

  • Knowledge and skills to effectively apply the following core Utilization Management functions:
    • Assessment - ID patients for Utilization Review; comprehensive collection of patient information and medical status; and continue evaluation of an established plan of care
    • Planning - Collaboration with the patient, family/caregiver, primary provider and other members of the health care team for developing an effective plan of care
    • Facilitation - Care coordination and communication among all involved parties
    • Advocacy - Support for the patient and family/caregivers to ensure identified education and appropriate, timely care is received.
      • Excellent communication skills
      •  Working with physically and/or mentally ill patients who may be uncooperative, fearful, emotionally distraught, and occasionally dangerous.
      • Organization, problem solving, and communication skills required to articulate medical requirements to patients, family/caregiver, medical and non-medical staff in a professional and courteous way.
    • This role will require utilization management experience in working with families, adults, children, seniors and groups.

    • The UM nurse will track ER and UC utilization, monitor high utilizers and coordinate with the PCM team and/or Case Manager, should be working with Referral Management Office for referral authorization approvals, ensure CPG criteria is being met, coordinate with the GPM regarding any leakage to the network and how the MTF can recapture those appointments.
    • Collaborating with the MTF Commanders on specific tasks.
    • Data extracting and organizing for presentations. 

 

REQUIREMENTS:

  • Baccalaureate of Science in Nursing Program from an approved National League of Nursing.
  • Six years of clinical nursing experience is required. One year of previous experience in
    Utilization Management is required. Full time employment in a nursing field within the last 36 months is
    mandatory.
  •  
  • Candidates should be familiar with Microsoft Office programs, MS Outlook (e-mail), and HIPPA guidelines. 

 

  • This role is for a medical professional on a military base. As part of the hiring process the candidate will be asked to provide credentialing documents including but not limited to: proof of education, copies of certifications and/or licenses, as well immunization records and other documents. 

 

Location: This position is located at 224 W D.L Ingram Ave, Bldg. 1408 Cannon AFB, NM 88103

 

About Clovis, New Mexico:

 

Clovis is a charming city situated in the heart of the High Plains. Surrounded by vast stretches of golden prairies, it offers a unique blend of small-town charm and Southwestern hospitality. Some highlights include:

 

  • Visit the beautiful Ned Houk Park, where you can walk the scenic trails, have a picnic by the lake, and more
  • Sample local flavors at one of the many eateries, where you can try authentic New Mexican cuisine and regional specialties
  • Children and adults alike will enjoy a visit to the Hillcrest Park Zoo, where you can explore over 140 acres
  • Visit the Clovis Civic Center, which hosts performances and exhibitions from local and touring artists

 

For more information, please contact:

Luis Angel Gonzalez, Recruiter

314-744-4157

Luis_Gonzalez@spectrumhealth.com

 

Company Overview:

Spectrum Healthcare Resources (SHR) was established in 1988 to deliver systems and processes designed to meet the unique needs of Military and VA Health Systems.  SHR is a leading organization that provides physician and clinical staffing and management services to United States Military Treatment Facilities, VA clinics and other Federal Agencies through various contracting vehicles.  A Joint Commission Health Care Staffing Services firm, SHR is the 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. 

 

Spectrum Healthcare Resources is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.

 

Location : Location: US-NM-Clovis Recruiter : Full Name: First Last: Luis Gonzalez Direct phone number: 314-744-4157 Recruiter : Email: Luis_Gonzalez@spectrumhealth.com Remote / Work from home available?: false

Required profile

Experience

Spoken language(s):
English
Check out the description to know which languages are mandatory.

Soft Skills

  • Excellent Communication
  • Organization
  • Problem Solving
  • Team Collaboration
  • Teamwork

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