Job description

THIS IS NOT A REMOTE OPPORTUNITY.

We are looking for a passionate RN Utilization Manager to join our team of skilled professionals and provide health care services to our veterans and their families at the US Air Force Academy in Colorado Springs, CO.

Great opportunity to be credentialed with a federal healthcare organization!

SCHEDULE:

• Monday – Friday : 7:30 – 4:30PM
• No nights, no weekends, no on-call, no overtime

BENEFITS:

• 2 weeks of vacation, 7 days of sick leave, 11 government holidays
• Health and wellness, dental, and vision insurance
• Life insurance
• Long and short-term disability
• 401K 2% matching
• Excellent work/life balance

Essential Duties & Responsibilities:

• Review precertification requests for medical necessity, referring to the Medical Director those that require additional expertise.
• Review clinical information for concurrent reviews.
• As part of the UMRN program, conduct ongoing availability, monitoring and oversight of non-clinical staff activities.
• Establish effective rapport with other employees, professional support service staff, customers, clients, patients, families, and physicians.
• Employ effective use of knowledge, critical thinking, and skills to:
• Advocate quality care and enhanced quality of life.
• Prevent patient complications during hospital stay.
• Advocate decreased hospital stay when appropriate.
• Maintain accurate records of all patient related interactions.
• Maintain regular and punctual attendance.
• Other duties as assigned.

Minimum Qualifications:

• Bachelor of Science in Nursing (BSN) is required.
• Minimum of 2 years of prior experience in Utilization Management or Referral Management.
• Must possess a current, active, full and unrestricted Registered Nurses (RN) licensed in Colorado, be able to practice using a nurse compact state license or have a license from any United States jurisdiction (with no limitations, stipulations or pending adverse actions).
• Utilization Management or Case Management certification preferred.
• Knowledge of medical privacy and confidentiality (Health Insurance Portability and Accountability Act [HIPAA]), and accreditation standards of Accreditation Association for Ambulatory Health Care (AAAHC), The Joint Commission (TJC), and Clinical Practice Guidelines (CPGs).
• Must have knowledge and experience, or demonstrate comprehension during training, with software and databases currently employed at the MTF (e.g. Microsoft Office, Access, Excel and PowerPoint; Composite Health Care System [CHCS], Armed Forces Health Longitudinal Technological Application [AHLTA]).
• Must have a working knowledge of Ambulatory Procedure Grouping (APGs), Diagnostic Related Grouping (DRGs), International Classification of Diseases-Current Version (ICD), and Current Procedural Terminology-Current Version (CPT) coding; and McKesson (InterQual) and/or Milliman Care Guidelines.
• Must possess and maintain current Healthcare Provider Basic Life Support (BLS) and current Advanced Cardiac Life Support (ACLS) certifications. These Certifications must be current at all times, at no additional expense to the government.
• Must obtain and maintain the site's required health screening and immunization requirements.
• Must obtain and maintain any necessary security access and/or background checks.
• Must obtain and maintain all required documents, certifications, licenses, etc. listed on the credentialing checklist, sent by Katmai’s Credentialing Specialist, for this position for initial hire.

Compliance:

To be considered for this position, all applicants must apply on the company website, https://katmaicorp.com/life-at-katmai/

• We are a VEVRAA Federal Contractor

We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity or national origin, disability status, protected veteran status, or any other characteristic protected by law. https://katmaicorp.com/life-at-katmai/#equal_opportunity Preference will be given to Ouzinkie Shareholders, Descendants of Shareholders, and Spouses of Shareholders in accordance with Title 43 U.S. Code 1626(g) and Title 42 U.S. Code 2000e - 2(i). Executive Order 11246, as amended, protects applicants and employees from discrimination based on inquiring about, disclosing, or discussing their compensation or the compensation of other applicants or employees.

Job Type: Full-time

Pay: $36.00 - $40.23 per hour

Benefits:

• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible schedule
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Physical setting:

• Hospital

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Experience:

• Utilization review: 2 years (Required)

License/Certification:

• RN (Required)
• BSN (Required)

Work Location: One location

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