Director of UM, Prisons

Naph Care
is hiring a Director
Of
Utilization, Prisons to join our team at the
Corporate Headquaters
located in
Birmingham, AL

Naph Care 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 6000 employees and growing!

Naph Care 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.

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

Naph Care Full Time Benefits:

• Prescriptions free of charge
  through our health plan
• Health, dental & vision insurance that
  starts day one
  !
• We offer low-cost benefits to our employees and their families
• Employment Assistance Program (EAP) services
• 401K and Roth with company contribution that
  starts day one!
• Tuition Assistance
• Referral bonuses
• On-site education
• Free Continuing Education!
• Term life insurance at no cost to the employee
• Generous paid time off & paid holidays

Naph Care 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 Naph Care Employees to meet state specific requirements for maintaining licensing.

With Naph Care, 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 s different.

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

Responsibilities for Director Of Utilization, Prisons

• Understanding of the principles and concepts of medical quality assurance and utilization review
• 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
• 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

Qualifications for Director Of Utilization, Prisons:

• A current and unrestricted RN license
• a minimum of 6 years’ experience in an acute care setting and 4 years’ experience in utilization review and/or case management
• Excellent communication and interpersonal skills
• attention to detailand decision-making skills are essential
• Valid CPR card