Job Description

Overview

NaphCare Alabama Prisons LLC is hiring a Regional Utilization Management Registered Nurse just like you for our Regional Office located in Montgomery AL where we manage all aspects of healthcare for the individuals who are currently incarcerated in the Alabama Department of Corrections .

As a Regional Utilization Management Registered Nurse you will work alongside correctional officers and other medical professionals who provide care to the individuals in residence. This is a unique position where you can make a difference to this diverse population of patients.

Responsibilities

• 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 discussing with physicians
• Reviews requests from providers regarding medical necessity of requested services for patients
• Reviews and audits patients medical records as indicated to determine medical necessity
• Utilizes nationally recognized criteria to determine medical necessity of requested services
• Refers 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 AL
• A minimum of 3 years experience in an acute care setting and 2 years experience in utilization review and/or case management
• Valid BLS CPR card (AHA preferred)
• Excellent communication and interpersonal skills
• Attention to detail and decision-making skills are essential
• BSN or ADN required.
• Some travel required

Why Join NaphCare

NaphCare Benefits for Full-Time Employees Include:

• 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

If you would like to speak with me to learn more about this position and NaphCare apply directly to the position to initiate the application process and Ill be in touch.

Equal Opportunity Employer: disability/veteran

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Required Experience:

IC

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