Spectrum Healthcare Resources has a potential opportunity for a civilian RN - Utilization Review at Elgin Air Force Base in Destin/Fort Walton Beach, Florida.
Position Highlights:
Excellent work/life balance Freedom from nights, weekends, and on-call11 paid federal holidays Give back & care for our Nation's armed forces
Requirements:
graduated from an accredited school of nursing with a Bachelor of Science in Nursing. Or an Associate Degree of Nursing maybe considered, with appropriate experience in emergency room services.
Unrestricted RN license -One year of previous experience in Utilization Management is required. Employment in a nursing field within the last 12 months is mandatory
American Heart Association or the American Red Cross Healthcare Provider (HCP) Certification BLSJob Duties Include but not limited to:
Develops and implements a comprehensive Utilization Management plan/program in accordance with the facility’s goals and objectives. 25Performs data/metrics collection on identified program areas; analyzes and trends results, including over- and underutilization of healthcare resources. Identifies areas for improvement and cost containment. Reports utilization patterns and provides feedback in a timely manner.Analyzes medical referrals/appointments and general hospital procedures and regulations by monitoring specialty care referrals for appropriateness, covered benefits, and authorized surgery/medical procedures, laboratory, radiology and pharmacy.Performs medical necessity review for planned inpatient and outpatient surgery; and performs concurrent review to include length of stay (LOS) for the facility’s surgery; and performs concurrent review to include length of stay (LOS) for the facility’s inpatients using appropriate criteria.Reviews previous and present medical care practices for patterns; trends incidents of under-or over-utilization of resources incidental to providing medical care.Acts as referral approval authority for designated referrals per local/AF/DoD/national guidance and standards. Refers all first-level review failures to the SGH or other POC for further review and disposition.
FMI contact:
Judi Brown
314-744-4135
Judi_Brown@Spectrumhealth.com
Company Overview:
At Spectrum, we utilize over thirty-five years of experience providing optimal solutions for federal agencies that are both innovative and cost-effective. We hold ourselves to the highest standard to ensure successful outcomes for the facilities and healthcare professionals we serve. As a Joint Commission Certified Healthcare Resource, dependability and service are the driving forces of our mission.
Spectrum Healthcare Resources is an equal opportunity employer. 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.
EOE/AA/Disability/Vet
Location : Location US-FL-Eglin AFB Recruiter : Full Name: First Last Judi Brown Direct phone number 314-744-4135 Recruiter : Email Judi_Brown@spectrumhealth.com Apply for this opportunity Apply for this job onlineApplyShare Sorry the Share function is not working properly at this moment. Please refresh the page and try again later. Share on your newsfeed Application FAQsSoftware Powered by iCIMS
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