Spectrum Healthcare Resources is seeking a dedicated and experienced RN Utilization Manager to join our team at Tinker Air Force Base. As an integral part of our healthcare team, you will play a vital role in ensuring the efficient and effective utilization of medical services for our service members and their families.
Position: RN Utilization Manager
Responsibilities:
- Utilize knowledge of medical privacy and confidentiality (HIPAA), as well as accreditation standards of AAAHC, TJC, and CPGs.
- Demonstrate proficiency in computer applications/software including Microsoft Office programs, MS Outlook (e-mail), and internet navigation.
- Apply working knowledge of Ambulatory Procedure Grouping (APGs), Diagnostic Related Grouping (DRGs), ICD, and CPT coding, as well as McKesson (InterQual) and/or Milliman Care Guidelines.
- Experience in Patient Advocacy, Patient Privacy, and Customer Relations.
- Conduct prospective, concurrent, and retrospective reviews to justify medical necessity for requested medical care and aid in collection and recovery from multiple insurance carriers.
Requirements:
- Bachelor's degree in Nursing (BSN) preferred.
- Active, unrestricted Registered Nurse (RN) license in any U.S. state or territory.
- Minimum of 36 months of total nursing experience in a direct patient care clinical setting within the last 48 months.
- Strong analytical skills and attention to detail.
- Excellent communication and interpersonal abilities.
- Ability to work effectively in a fast-paced environment.
Benefits:
- Competitive salary based on experience and qualifications.
- Comprehensive benefits package including medical, dental, and vision coverage.
- 401(k) retirement plan with company match.
- Paid time off and holidays.
- Professional development and training opportunities.
- Supportive work environment with opportunities for growth and advancement.
How to Apply: If you meet the requirements and are ready to make a difference in the lives of our service members, we would love to hear from you! Please submit your resume, cover letter, and contact information to Niqcardo_calhoun@spectrumhealth.com.
About Spectrum Healthcare Resources: Spectrum Healthcare Resources is a leading provider of healthcare staffing and management solutions. We are committed to delivering exceptional care to those who serve our country. Join us in making a positive impact on the lives of our nation's heroes and their families.
Don't miss this opportunity to join a dedicated team and contribute to the health and well-being of our military community. Apply today and be part of something meaningful!
Contact: Niqcardo Calhoun, HR Manager Email: Niqcardo_calhoun@spectrumhealth.com Phone: 314-744-4237
Spectrum Healthcare Resources is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
