Utilization Manager RN GiaCare Inc
Overview
Join GiaCare Inc as a Utilization Manager RN supporting MacDill Air Force Base. This full-time role involves conducting utilization reviews and supporting efficient care for service members retirees and families. We are recruiting in anticipation of a contract award.
What You'll Do6
- 1Conduct utilization review and medical necessity determinations using established clinical criteria
- 2Review admissions continued stay and level-of-care decisions in coordination with providers
- 3Support the facility's utilization management program and related reporting requirements
- 4Collaborate with case management providers and MTF leadership on utilization trends
- 5Accurately and timely report data through required government reporting systems
- 6Document review activity within the electronic medical record
Requirements9
- 1U.S. Citizen U.S. national lawful permanent resident or individual otherwise authorized to work in the United States
- 2Associate's Degree of Nursing current full active unrestricted Registered Nurse license in any U.S. state territory or District of Columbia
- 3Prior clinical nursing experience; utilization review utilization management experience strongly preferred
- 4Current Basic Life Support certification (or willing to obtain)
- 5Able to pass Tier 1 background investigation for facility and network access
- 63 years in last 4 years as a registered nurse in utilization management
- 7Experience applying InterQual MCG or comparable utilization review criteria
- 8Experience in utilization management within a military treatment facility or managed-care setting
- 9Strong analytical documentation and cross-team communication skills
Salary Insight
Salary not disclosed in listing
Location
Required Skills
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