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Spectrum Healthcare Resources, Inc. Registered Nurse Expert in Dayton, Ohio

Registered Nurse ID 2024-22415 Category Hidden (17466) Facility DOD / MTF - Ohio - Wright Patterson Air Force Base Job Description Spectrum Healthcare Resources has an Exciting Potential Opportunity for a Registered Nurse-Utilization Management supporting Wright Patterson Air Force Base in Dayton, OH. Job Requirements: Degree/Education: Graduate from an associate degree program in nursing accredited by the Accreditation Commission for Education in Nursing (ACEN), the Commission on Collegiate Nursing Education (CCNE) or national nursing agency that is recognized by the US Department of Education. Bachelor's degree in nursing preferred. 4 years full-time specific utilization management experience. HCWs are required to maintain Continuing Education as required by their State Board of Nursing. Licensure/Registration: Current, full, active, and unrestricted license to practice as a Registered Nurse. Licensed in good standing and cannot be under investigation nor have any adverse action pending from a Nursing State Board or national licensing/certification agency. Licensing status must be unrestricted. Experience: A minimum of four (4) years' experience in discharge planning or case management is required for consideration of a candidate with an associate degree in nursing. Two years full-time experience in utilization management is required for graduates with a Bachelor of Science in Nursing. Full time employment in a nursing field within the last 36 months is mandatory. Board Certification: Certified in a clinical specialty recognized by American Nurses Credentialing Center -OR- certification eligible. BLS through American Heart Association Duties: Not limited to; Assist inpatient discharge planning when needed, as directed. Duties may include home safety patient/family interview, attending morning planning meeting, and coordinating transfers, home durable medical equipment and/or home care services, inpatient rehab, and/or skilled care. Develop and implement a comprehensive Utilization Management plan/program in accordance with MTF/AF/DHA goals and objectives. Perform data/metrics collection on identified program areas; analyzes and trends results, including over- and underutilization of healthcare resources and ineffective or inefficient delivery of care. Identifies areas for intensive management, improved and/or cost containment. Reports utilization patterns, provides feedback, and makes recommendations in a timely manner. Analyze medical referrals/appointments and general hospital procedures by monitoring specialty care referrals for appropriateness, covered benefits, and authorized surgery/medical procedures, laboratory, radiology, and pharmacy. Evaluate clinical practice patterns and trends and provides SGH and clinical areas with feedback. Identify and refer potential cases to Disease Management, Case Management, Discharge Planning, and the Deployment Availability Working Group. Participate in Medical Management, Population Health Working Group, and care coordination meetings as assigned. Conduct nursing peer review as assigned. Educate Patient Centered Medical Home (PCMH) staff on UM role. Position will Offer: Full time; Monday - Friday PTO and sick leave Paid federal holidays Medical/Dental/Vision/401k For More Information Contact: Laura Hatcher 314-744-4156 Laura_Hatcher@spectrumhealth.com Company Overview: Spectrum Healthcare Resources (SHR) was established in 1988 to deliver systems and processes designed to meet the unique needs of Military and VA Health Systems. SHR is a leading organization that provides physician and clinical staffing and management services to United States Military Treatment Facilities, VA clinics and other Federal Agencies through various contracting vehicles. A Join

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