RN Utilization Review Other
Spectrum Healthcare Resources

Utilization Management Registered Nurse

Spectrum Healthcare Resources Cheyenne, WY, US
$39 - $48 / hour
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Job Description

Spectrum Healthcare Resources has an excellent opportunity for a civilian Utilization Management Registered Nurse at FE Warren Air Force Base in Cheyenne, WY. 

 

  • Full-time opportunity
  • Monday - Friday (0700-1700)
  • No weekends, on-call or holidays required
  • Provide care and resources to military community
  • Full complement of benefits to include health, dental and vision insurance, PTO, 11 Paid Holidays, 401(k) and more
  • Pay range is $39-48/hour

Job Requirements:

  • BSN Degree
  • 6 years of clinical nursing experience and 1 year of utilization management experience required
  • Knowledge, skills and computer literacy to interpret and apply medical care criteria, such as InterQual or Milliman Ambulatory Care Guidelines.
  • Experience in performing prospective, concurrent, and retrospective reviews to justify medical necessity for medical care to aid in collection and recovery from multiple insurance carriers. 
  • Current RN license in Wyoming

 

Job duties:

  • Monitor specialty care referrals for appropriateness, covered benefit, and authorized surgery/medical procedures, laboratory, radiology, pharmacy, and general hospital procedures and regulations to analyze medical referrals/appointments. 
  • Receives and makes patient telephone calls and computer/written correspondence regarding specialty clinic appointments and referrals.
  • Develops and implements a comprehensive Utilization Management plan/program for beneficiaries within MTF’s goals and objectives. 

Company Overview:

 

At Spectrum, we utilize over thirty-five years of experience providing optimal solutions for federal agencies that are both innovative and cost-effective. We hold ourselves to the highest standard to ensure successful outcomes for the facilities and health care professionals we serve. As a Joint Commission Certified Healthcare Resource, dependability and service are the driving forces of our mission. 

 

EOE/Disabled/Veterans

Location : Location

US-WY-Cheyenne

Recruiter : Full Name: First Last

Lauren Larkin

Direct phone number

571-410-2088

Recruiter : Email

Lauren_Larkin@spectrumhealth.com

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