• Utilization Management Registered Nurse

    Job
    18-55896
    Location
    FL, Pompano Beach
    Facility
    Paul Rein Detention Facility, BR CO
    Type
    Regular Full-Time
    Shift
    Day
    Recruiter
    Jacquelynne Mullins
    Email
    JaMullins@CorrectCareSolutions.com
  • Overview

    Our UM Nurse will assist with analyses of medical necessity, level of care, care progression, and resource utilization.

    Qualifications

    Education:           

    • Graduation from an accredited School of Nursing

    Experience:        

    • Previous experience working with utilization management
    • Computer data entry experience

    Licenses/Certifications: 

    • Current licensure as a Registered Nurse

    Responsibilities

    1. Utilizes nationally recognized evidence-based criteria to determine medical necessity of requested services, diagnostics, specialty care, or inpatient care.
    2. Refers provider requests when the requested services do not meet the recognized criteria.
    3. Coordinate with healthcare staff and providers to plan for discharge back to DOC institutions.
    4. Reviews information to determine the level of care or the medical necessity of any services requested by a provider.
    5. Reviews and audit inmate medical records to determine what services or procedures are medically necessary.
    6. Must be able to obtain and maintain security clearance.
    7. Must be able to apply principles of critical thinking to a variety of practical and emergent situations and accurately follow standardized procedures that may call for deviations.
    8. Must be able to apply sound judgment beyond a specific set of instructions and apply knowledge to different factual situations.
    9. Must be alert at all times; pay close attention to details.
    10. Must be able to work under stress on a regular or continuous basis.
    11. Post orders, if applicable, per site contract.
    12. Perform other duties as assigned.

    CCS is an EOE/Minorities/Females/Vet/Disability Employer

    Options

    Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.
    Share on your newsfeed

    Not ready to apply? Connect with us to be the first to hear about new opportunities Click Here

    Joining our Talent Community will enhance your job search and application process.
    Advantages Include:
          • Receive alerts with new job opportunities that match your interests
          • Receive relevant communications and updates from Correct Care Solutions
          • Share job opportunities with family and friends through Social Media or email

    So, Click Here to Join our Talent Community today!