[Hiring] Utilization Management Registered Nurse @Naphcare, Inc.

Role Description

NaphCare is hiring an experienced Utilization Management Registered Nurse just like you to join our Remote based, Arizona team.

• Develop, implement, and administer the quality assurance and utilization review processes
• Monitor and report on the quality of all facets of the medical care provided to patients
• Perform utilization and concurrent review of patient cases
• Conduct detailed clinical chart assessments
• Gather clinical information to assess and expedite care needs
• Determine need, if any, for intervention, and discuss with physicians
• Review requests from providers regarding medical necessity of requested services for patients
• Review and audit patients' medical records as indicated to determine medical necessity
• Utilize nationally recognized criteria to determine medical necessity of requested services
• Refer provider requests to Medical Director or designee when medical necessity of requested services does not meet recognized criteria

Qualifications

• A current and unrestricted RN license in Arizona
• A minimum of 3 years’ experience in an acute care setting and 2 years’ experience in utilization review and/or case management
• Valid CPR card
• Excellent communication and interpersonal skills
• Attention to detail and decision-making skills are essential
• BSN or ADN required
• Some travel required

Requirements

• Must have the ability to stand for long periods
• Lift and move patients (up to 50 pounds)
• Bend, squat, reach, push, pull, walk significant distances
• Perform physically demanding tasks like CPR
• Maintain good balance and endurance throughout a shift

Benefits

• Health, dental & vision insurance that starts day one!
• Prescriptions free of charge through our health plan, beginning day one!
• Lowest Cost Benefits!
• Employee Assistance Program (EAP) services
• 401K and Roth with company contribution that starts day one!
• Tuition Assistance
• Referral bonuses
• Term life insurance at no cost to the employee
• Generous paid time off & paid holidays
• Free continuing education and CMEs