RN - Utilization Management

Spectrum Healthcare Resources

$75K — $90K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's Nursing Degree required
  • Active state nursing license, preferably compact state licensure
  • Minimum 2 years' experience as a UMRN, ideally remote or hybrid
  • Current certification in either CPUR program or CCM
  • Strong organizational and self-directed working skills
  • Effective verbal and written communication skills
  • Proficient in Microsoft Office and strong technical aptitude

Responsibilities

  • Review healthcare cases for adherence to guidelines
  • Educate patients on appropriate care options
  • Manage healthcare costs for dependents of active duty and retirees
  • Collaborate with medical professionals to optimize patient care
  • Function autonomously in high-volume remote setting
  • Maintain accurate records of patient interactions
  • Utilize technology to track and manage cases effectively

Benefits

  • Completely remote work arrangement
  • Monday through Friday schedule
  • Support roles focused on the nation's military and retirees
  • Engagement with a diverse patient population
  • Opportunity for professional development in utilization management
Full Job Description
Job Description

Spectrum Healthcare Resources has a need for a Utilization Manager Registered Nurse (UMRN). These will be completely remote positions, working entirely from the Nurse's home. The Nurse will be reviewing cases, educating patients on appropriate care and managing health care costs for the dependents of our Nation's Active Duty and eligible retirees.

The Nurse will be working remotely Monday through Friday, 8 hours per day.

Requirements
  • Bachelors Nursing Degree
  • At least one active state nurse license, preferably compact state licensure
  • At least 2 years' experience working as a UMRN, preferably in a remote or hybrid environment.
  • Possess current certification in either
    • Completion of an accredited Certified Professional Utilization Review (CPUR) program
    • Certified Case Manager (CCM) issued by the Commission for Case Manager Certification.

-OR-
  • Possess two (2) years of full-time broad based registered nurse experience in a utilization management review or a case management setting within the preceding five (5) years. Notwithstanding the aforementioned experience requirements, the HCWs must have pertinent clinical experience within the past two (2) years sufficient to demonstrate current clinical competency for the setting and procedures required by this contract.
  • Highly organized, self-directed worker able to function in a high-volume environment without distractions.
  • Strong verbal and written communication skills.
  • Proficient level of experience with Microsoft Office applications and strong technical aptitude.
  • Must have access to secure, high speed internet.


Location : Location

US-HI-Honolulu

Recruiter : Full Name: First Last

Joseph Day

Direct phone number



Recruiter : Email

[email protected]

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