Utilization Management RN

Utilization Management RN

Join to apply for the Utilization Management RN role at VITALCARE MEDICAL PRACTICE.

Vital Core Health Strategies (VCHS), an industry leader in Correctional Healthcare, has an opening for a Utilization Management RN at the Regional Office in Dover, Delaware.

• Holiday Pay:
  New Year’s Day, Martin Luther King Jr. Day, Memorial Day, Juneteenth, Independence Day, Labor Day, Veteran’s Day, Thanksgiving Day, and Christmas Day
• Medical/Dental/Vision Insurance
• Life Insurance
• Short Term/Long Term Disability
• Identity Theft Protection
• Animal/Pet Insurance
• Employee Assistance Program and Discount Center
• 401
  
  KEEO PTO Annual Incentive Bonus

• Serve as a Regional Office Case Manager for an incarcerated population, advocating for optimum healthcare.
• Maintain accurate, detailed reports and confidential records.
• Be familiar with all roles and tasks within the utilization management division, including cross‑training in all areas.
• Provide coverage in the absence of the UM Director or as requested.
• Complete both Medicaid and Reentry (as requested) assist application processes.
• Track and log tasks as directed by UM Director utilizing SharePoint, TEAMS, Excel, etc.
• Facilitate Care Management call daily with site leadership, maintain Care Management log daily.
• Maintain Emergency Room Inpatient (ERIP) log and submit daily.
• Facilitate Grand Rounds with providers daily and maintain tracking log.
• Assist in the transition of acute or complex offenders from the hospital back to the various sites.
• Multi‑task various utilization management tasks, while being available to assist others as needed or requested.
• Assist in the education of Vital Core employees as needed or requested regarding Vital Core's utilization management processes, purpose and goals.
• Professionally and positively greet and interact with the DOC (client), Vital Core employees, community partners and any regional office visitors.
• Rotate/share the end of the month responsibilities related to offenders admitted to a hospital on the last day of the month.
• Attend any meetings required or requested by Vital Core leadership. Additional duties as assigned by regional office.

• Graduate of an accredited School of Nursing.
• Licensure as a Registered Nurse in the state of employment (or compact license).
• Possesses an active CPR certification.
• Remains knowledgeable about specific state laws and regulations governing practice.
• Satisfactory completion of initial and annual clinical competencies to demonstrate aptitude as assigned by role.

• Full‑Time, 40‑hour week.
• Entry Level.

Salary: $71,100.00‑$97,800.00 (Delaware).

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