Utilization Management Registered Nurse

Overview

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

NaphCare is a family owned, healthcare technology company that has been delivering high quality healthcare to correctional facilities across the nation for over 35 years.  Come join our team of over 5000 employees and growing!  NaphCare pays well, offers outstanding benefits, and has an incredibly engaged corporate support team to make sure you have what you need to be truly excellent at what you do. 

NaphCare partners with correctional facilities to provide proactive, patient-focused healthcare.  

NaphCare has a partnership with NetCE that provides CEU/CME for our staff. NetCE uses a rigorous peer review process to ensure that all activities and content are up-to-date. This service streamlines continuing education for all NaphCare Employees to meet state specific requirements for maintaining licensing. 

With NaphCare, you'll play a critical role in our continuing mission to be the leading provider of quality healthcare in the correctional industry.  If you want a career that will make a difference, choose the company that is different.

We support your growth and internal promotion.  Once hired, we encourage our employees to continue to seek opportunities for advancement and leadership.

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 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.

Physical Capabilities:

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, and perform physically demanding tasks like CPR, all while maintaining good balance and endurance throughout a shift.

Why Join NaphCare?

NaphCare is one of the largest providers of healthcare services to correctional facilities throughout the US and we are growing. If you have never considered a career in correctional healthcare, now may be the time. In addition to competitive salaries and generous employee benefits, we strongly support career advancement within the company.

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 I’ll be in touch.

Equal Opportunity Employer: disability/veteran

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