Registered Nurse (RN) - Utilization Management

Registered Nurse Utilization ManagementSpectrum 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-430pmOutpatient ClinicNo Nights, Weekend or HolidaysNo On-CallStable Patient PopulationPaid time off and paid holidaysBenefits 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 CCNEActive RN license in any state2+ years of clinical and utilization management RN experienceBasic Life Support Certification from American HeartCore 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 referralsResearch 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 View email address on click.appcast.io 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. EOE/Disabled/Veterans