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Registered Nurse (RN) Utilization Management

$67.38 per hour

Matrix Providers

Matrix Providers is hiring a Registered Nurse (RN) Utilization Management to join our team of talented professionals who provide health care services to our Military Service Members and their families in Fairfield CA.

  • Employment Status: Full Time
  • Compensation: This is an hourly position paid bi-weekly.
    • $67.38/hour plus $5.42 H&W
  • Schedule: Monday thru Friday 07:30 am - 4:30 pm
  • Benefits: Competitive financial package with a comprehensive insurance package including health dental vision and life coverage.
    • Accrued Paid Time Off (PTO)
    • Paid Holidays (Outlined in Handbook)
    • 401(k) Plan

Requirements: The Registered Nurse (RN) must have and meet the following:

  • Degree: Associates Degree in Nursing.
  • Education: Graduate from a college or university accredited by Accreditation
    Commission for Education in Nursing (ACEN) National League for Nursing Accrediting
    Commission (NLNAC) the Commission on Collegiate Nursing Education (CCNE)
  • C ertifications in addition to Basic Life Support: Possess one of the following
    certifications: American Nurses Credentialing Center (ANCC) Nurse Case Manager
    (RN-NCM) National Academy of Certified Care Managers: Care Manager Certified
    (CMC) OR Commission for Case Manager Certification (CCMC): Certified Case
    Manager (CCM) or American Nurses Credentialing Center (ANCC) -OR- have practiced
    the equivalent of 2 years full-time as a registered nurse and have a minimum of 2000
    hours of clinical practice in nursing case management within the last 3 years and have
    completed 30 hours of continuing education in nursing case management within the last 3
    years.
  • Experience: Twelve (12) months of recent full-time experience in nursing/health care
    management for adults children families seniors or groups is required.
    • Possess a thorough clinical knowledge and breadth of experience to be able to contribute to population level assessment and management identify appropriate Case Management candidates conduct patient self-care education and track patient outcomes.
    • Extensive knowledge of CM components: outcomes measurement collaborative practice patient self management population identification processes and process improvement.
  • Licensure: Current full active and unrestricted license to practice as a Registered Nurse.
  • Location - Travis AFB David Grant Medical Center.

Job Summary:

  • Must possess organization problem-solving and communication skills to articulate
    medical requirements to patients families/care givers medical and nonmedical staff in a
    professional and courteous way.
  • Must have the knowledge and skills to effectively apply the following core case
    management functions: a) Assessment: Identification of patients for case management;
    comprehensive collection of patient information and medical status; and continued
    evaluation of an established plan of care; b) Planning: Collaboration with the patient
    family/caregiver primary provider and other members of the health care team for
    developing an effective plan of care; c) Facilitation: Care coordination and
    communication among all involved parties; d) Advocacy: Support for the patient and
    family/caregivers to ensure identified education and appropriate timely care is received.
  • Must be skillful and tactful in communicating with people who may be physically or
    mentally ill uncooperative fearful emotionally distraught and occasionally dangerous.
  • Must be knowledgeable in medical privacy and confidentiality (Health Insurance
    Portability and Accountability Act HIPAA); accreditation standards of Accreditation
    Association for Ambulatory Health Care (AAAHC) and The Joint Commission (TJC);
    and computer applications/software to include Microsoft Office programs MS Outlook
    (e-mail) and internet familiarity is required.
  • Identification of patients for case management; comprehensive collection of patient
    information and medical status; and continued evaluation of an established plan of care.
  • Conduct CM staff peer reviews using approved peer review form as assigned.
  • Proactively implement CM services for populations with chronic conditions collaborate
    with beneficiaries in formulating patient-centered goals and educate individuals their
    families or caregivers.
  • Provide a warm handoff (person-to-person verbal communication providing continuity of
    care and a seamless transfer of information) of patients in transition to other levels or
    places of care by providing pertinent information to the receiving health care provider
    document warm handoff communications.
  • Serves as patient advocate and liaison to healthcare and community agencies for matters
    concerning primary secondary and tertiary healthcare services. Actively participates as
    team member or facilitator of committee or working group.
  • Attend multidisciplinary rounds ward meetings/discharge planning meetings as required
    to ensure multidisciplinary collaboration and optimal effective communication.
  • When possible ensure the patients families and care givers are involved in the case
    management process. Act as a point of contact when there are complex arrangements to
    be organized for patients.
  • Completes and appropriately documents an assessment of patient family and caregiver
    readiness identifies individual health care needs and proactively coordinates chronic
    condition care follow-on care.
  • Be able to perform with minimal supervisory direction. Be able to independently identify
    plan and carry out projects with consideration for the goals and objectives of the MTFs
    Utilization Management and Medical Management Departments.
  • Assessment: Proactively identifies and evaluates patients and families for case
    management from a variety of sources such as discharge/disposition planning referrals
    the Medical Evaluation Board (MEB) process the healthcare system employers and
    facility staff. Conducts systematic on-going thorough collection of patients physical
    emotional psychological social and medical status and information via direct patient
    contact and other relevant sources such as professional and non-professional caregivers
    medical records family/caregiver interviews.
  • Planning: Develops an appropriate patient-specific plan of care to include short and long
    term goals objectives and actions. Coordinates collaborates and obtains approval of the
    plan among the patient family/caregiver primary provider and other members of the
    healthcare team.
  • Implementation: Guides the patient and family/care giver through the healthcare system maximizing use of resources. Coordinates and executes the plan of care optimizing access to appropriate services. Ensures necessary referrals are ordered by the appropriate discipline and coordinated. Serves as an advocate for and ensures education is provided to the patient and family/caregiver as required. Promotes adherence to treatment plans for improved healthcare outcomes.
  • OTHER job duties to be provided with official Job Description

Matrix Providers will never request any form of payment from candidates in exchange for consideration for employment. Furthermore all communication from Matrix Providers will be conducted exclusively through official Matrix Providers email addresses. Any correspondence from alternative email addresses should be considered fraudulent.

Matrix Providers is an equal opportunity employer. Qualified applicants will receive consideration for employment regardless of race color religion sex sexual orientation gender identity national origin disability or protected veteran status. For our EEO Policy Statement please see To learn more about our Benefits Packages please see

Matrix Providers endeavors to make accessible to all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process please get in touch with our Recruiting Hotline Number 1- TTY LINE . This contact information is for accommodation requests only and cannot be used to inquire about the status of applications.

Required Experience:

IC

Vacancy posted 9 days ago
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