Spectrum Healthcare Resources has an excellent opportunity for a civilian Utilization Management Registered Nurse at FE Warren Air Force Base in Cheyenne, WY.
- Full-time opportunity
- Monday - Friday (0700-1700)
- No weekends, on-call or holidays required
- Provide care and resources to military community
- Full complement of benefits to include health, dental and vision insurance, PTO, 11 Paid Holidays, 401(k) and more
- Pay range is $39-48/hour
Job Requirements:
- BSN Degree
- 6 years of clinical nursing experience and 1 year of utilization management experience required
- Knowledge, skills and computer literacy to interpret and apply medical care criteria, such as InterQual or Milliman Ambulatory Care Guidelines.
- Experience in performing prospective, concurrent, and retrospective reviews to justify medical necessity for medical care to aid in collection and recovery from multiple insurance carriers.
- Current RN license in Wyoming
Job duties:
- Monitor specialty care referrals for appropriateness, covered benefit, and authorized surgery/medical procedures, laboratory, radiology, pharmacy, and general hospital procedures and regulations to analyze medical referrals/appointments.
- Receives and makes patient telephone calls and computer/written correspondence regarding specialty clinic appointments and referrals.
- Develops and implements a comprehensive Utilization Management plan/program for beneficiaries within MTF’s goals and objectives.
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 health care professionals we serve. As a Joint Commission Certified Healthcare Resource, dependability and service are the driving forces of our mission.
EOE/Disabled/Veterans
