Registered Nurse - Utilization Management

Overview

ERP International is seeking a Registered Nurse - Utilization Management (RN) for a full-time position supporting Hill AFB, UT 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 have been named one of The Washington Post's 2022 Top Workplaces!

* Excellent Compensation & Exceptional Comprehensive Benefits!
* Paid Vacation, Paid Sick Time, Plus 12 Paid Federal Holidays!

* Medical/Dental/Vision, STD/LTD/Life, 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

Schedule:

Monday - Friday, 9 hours including a one hour lunch between 7:00am and 5:00pm

No weekends or holidays

No Call

Job Specific Duties:

Core Duties:

• Assist with orientation and training of other Medical Management staff and assist in providing, assessing, and improving a wide variety of customer service relations. Assists MTF officials to ensure Health Service Inspection standards are met at the operational level.
• Assists in the development and implementation of a comprehensive Utilization Management plan/program for beneficiaries within MTF's goals and objectives. This plan is based on using the 12-step approach as described in the DoD Medical Management Guide.
• Reviews previous and present medical care practices as needed for patterns, trends, or incidents of under or over utilization of hospital resources incidental to medical care provided to beneficiaries.
• Plans and performs reviews IAW established indicators and guidelines to provide quality cost-effective care. Ensures identified patient needs are addressed promptly with appropriate decisions. Provides timely, descriptive feedback regarding utilization review issues.
• 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 Identifies areas requiring intensive management or areas for improvement.
• Serves as a liaison with higher headquarters, TRICARE Regional Office, MTF national accreditation organization, professional organizations, and community health care facilities concerning Utilization Management.
• Participates in in-services and continuing education Briefs applicable data/slides to provider staff, executive staff, newcomers, as appropriate.
• Establishes and maintains good interpersonal relationships with co-workers, families, peers, and other health team Submits all concerns through Utilization Management Director; be able to identify, analyze and make recommendations to resolve problems and situations regarding referrals.
• Be productive and perform with minimal oversight and direction. Be able to independently identify, plan, and carry out projects with consideration for the goals and objectives of the TRICARE Utilization Management Element. Develops detailed procedures and guidelines to supplement established administrative regulations and program Recommendations are based upon analysis of work observations, review of procedures, and application of guidelines.

Qualifications

Minimum Qualifications:

* Education: Minimum BSN.

* Experience: Minimum 6 years clinical nursing experience is required. 1 year of previous experience in Utilization Management is required. Full time employment in a nursing field within the last 36 months is mandatory.

* License: Active unrestricted RN license from any state

* Life Support Certifications: Possess current AHA or ARC BLS certification.

* Security: Must possess ability to pass a Government background check/security clearance.