FSR (Federal Staffing Resources)
  • Nellis AFB, NV, USA
  • Full Time

Job Opening for a Registered Nurse (RN) Utilization Management in Las Vegas, NV. 

The Registered Nurse (RN) position is Monday - Friday DAYS only! Incumbents, please reach out to us. 

The hospital is located on Nellis Air Force Base and the Registered Nurse (RN) Utilization Management position is a civilian position providing services within the extensive military medical system, which provides services to active duty service members, military retirees, and their families. Civilian and military personnel work together in the hospitals and clinics. The employment is contingent upon contract award. It is a wonderful opportunity to work in a fantastic medical system serving an inspiring patient population. 

Registered Nurse (RN) Utilization Management Position overview:

  • Develop and implement a comprehensive Utilization Management plan/program in accordance with the facility's goals and strategic objectives.
  • Analyze medical referrals/appointments and general hospital procedures and regulations by monitoring specialty care referrals for appropriateness, covered benefits, and authorized surgery/medical procedures, laboratory, radiology and pharmacy.
  • Perform medical necessity review for planned inpatient and outpatient surgery
  • Perform concurrent review to include length of stay for the facility's inpatients using appropriate criteria
  • Act as referral approval authority for designated referrals
  • Ensure and monitor specialty care referrals for appropriateness, medical necessity, and if the appointment, diagnostic testing, or procedure requested is a covered benefit according to appropriate health plan. 
  • Receive and make patient telephone calls, written, or e-mail correspondence regarding specialty clinic appointments and referral
  • Keep abreast of MTF and local market services and capabilities
  • Conduct referral reconciliation report, identifying all open referrals, and provides notification to appropriate personnel for resolution.
  • Serve as a liaison with headquarters, TRICARE regional offices, facility staff and professional organizations concerning Utilization Management practices
  • Collaborate with staff and departments
  • Participate in the orientation, education and training of other staff
  • Complete medical record documentation and coding, and designated tracking logs and data reporting

Registered Nurse (RN) Utilization Management Requirements:

  • HIPAA and accrediation standards for AAAHC, TJC, and CPGs knowledge
  • Patient Advocacy, Patient Privacy, and Customer Relations experience
  • Certified or Certified Eligiable in relevant specialty, such as Certified Managed Care Nurse, Ambulatory Care Nursing, Medical-Surgical Nursing or Nursing Case Management through the American Nurses Credentialing Center
  • 3 years of nursing experience in a direct patient care clinical setting
  • 24 recent consecutive months of Utilization management, utilization review or case management experience
  • RN license (any U.S. state or Territory license honored) 

 

 Registered Nurse (RN) Utilization Management position benefits:

  • Competitive Compensation 
  • Health, Dental, and Vision plans
  • Monday-Friday
  • Days Only
  • PTO - fantastic accural rate
  • 10 paid Federal Holidays

 


FSRpeople.com

FSR provides healthcare professionals to government healthcare facilities supporting active military service members, retirees, and their families nationwide. Since 2004, FSR has matched talented individuals to organizations to create mutually beneficial, sustainable partnerships. FSR is a well-established, award winning organization built with committed professionals who have a unified vision of helping others to succeed and thrive. Position contingent upon contract award. 

We invite you to join our team and grow with us!

FSR is a woman-owned, minority, small business based out of Maryland.

 

Federal Staffing Resources dba FSR is an Equal Opportunity Employer: disability/veteran/military spouse

This contractor and subcontractor shall abide by the requirements of 41 CFR 60-1.4(a), 60-300.5(a) and 60-741.5(a). These regulations prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, sexual orientation, gender identity or national origin. Moreover, these regulations require that covered prime contractors and subcontractors take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disability.

FSR (Federal Staffing Resources)
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