Job Information
ERP International Registered Nurse (RN) Utilization Manager in Corpus Christi, Texas
Overview
ERP International is seeking a Registered Nurse (RN) Utilization Manager for a full-time position in support of the Naval Health Clinic Corpus Christi, TX. Apply online today and discover more about this exceptional employment opportunity. www.erpinternational.com
Be the Best! Join our team of exceptional health care professionals across the nation. Come discover the immense pride and job satisfaction ERP Employees experience in providing care for our Military Members, their Families and Retired Military Veterans! ERP International is honored to be named a 2024 Top Workplace by The Washington Post! 5 Years Running
Full-time W2 Options:
* Excellent Compensation & Exceptional Comprehensive Benefits!
* Paid Vacation, Paid Sick Time, Plus 11 Paid Federal Holidays!
* Medical/Dental/Vision, STD, LTD and Life Insurance, Health Savings Account available, and more!
* Annual CME Stipend and License/Certification Reimbursement!
* Matching 401K!
About ERP International, LLC: ERP is a nationally respected provider of health, science, and technology solutions supporting clients in the government and commercial sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states. Founded in 2006, ERP is headquartered in Laurel, MD and maintains satellite offices in Montgomery, AL and San Antonio, TX - plus project locations nationwide. ERP is an Equal Opportunity Employer - Disability and Veteran.
Responsibilities
Work Schedule:
Monday - Friday, between the hours of 7:30am and 4:30pm, to include a lunch break
No Weekends, No Holidays
Job Specific Position Duties: The duties include, but are not limited to the following:
• Assist with orientation and training of other Medical Management staff. Assists MTF officials to ensure Health Service Inspection standards are met at the operational level.
• Performs data/metric collection. Analyzes data and prepares reports to describe resource utilization patterns. Briefs applicable data/slides to provider staff, executive staff, newcomers, as appropriate. Identifies areas requiring intensive management or areas for improvement.
• 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 in in-services and continuing education programs. Briefs applicable data/slides to provider staff, executive staff, newcomers, as appropriate.
• Participate in all phases of the Utilization Management Program (UMP) and ensure that the UMP meets established Utilization Management (UM) standards of care. Assist in coordinating a multidisciplinary team to meet the health care needs, including medical and/or psychosocial management of specified patients. Perform a full range of utilization management services including referrals, care coordination, utilization review, discharge planning, continued stay reviews, and appeal reviews.
• Serve as consultant to all disciplines regarding UM issues. Provide nursing expertise about the UM process, including assessment, planning, implementation, coordination, and monitoring.
• Collect and analyze clinical utilization data to identify information on resource consumption and outcomes of care.
• Develop and implement tools to support utilization management, such as those used for patient identification and patient assessment, clinical practice guidelines, algorithms, UM software, databases for community resources, etc.
• Prepare routine reports and conduct analyses relating to Utilization Management initiatives.
Qualifications
Minimum Qualifications:
* Education: BSN
* Experience: 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. Equivalent combinations of education and experience may be qualifying if approved by the requesting location and the Contracting Officer. If education or experience is used to meet the specialized requirements of this position, it must be directly related to referral/utilization management.
* License: Active, unrestricted RN license
* Board Certification: N/A
* Life Support Certifications: BLS
* Security: Must be able to pass a Government background check and obtain a Government security clearance.
Job Locations US-TX-Corpus Christi
Posted Date 1 week ago (9/6/2024 3:35 PM)
Job ID 2024-4666
Category Clinical