Utilization Management RN

Vital Core Health Strategies (VCHS) has a full‑time opening for a Utilization Management RN at the Regional Office in Hopkinton, MA.

• Serve as a Regional Office Case Manager for an incarcerated population, advocating for optimum healthcare.
• Maintain accurate, detailed reports and confidential records.
• Consult and coordinate with healthcare team members to assess, plan, implement, or evaluate patient care plans.
• Modify patient treatment plans as indicated by patients’ responses and conditions.
• Review all aspects of facility patient care.
• Review referrals for offsite treatment and care for appropriateness and best utilization of resources.
• Act as a liaison with all offsite providers, both specialty and hospitals.
• Review medical transports to Emergency Departments to ensure continuity of care.
• Oversee hospitalized cases, including reviewing daily clinicals and providing information to facility MD and team.
• Assist with hospital discharge planning to ensure goals of care are met.
• Seek infirmary‑level bed placement when higher level care is required.
• Perform additional duties as assigned by the regional office.

• Graduate of an accredited School of Nursing.
• Licensure as a Registered Nurse in the state of employment with 1+ years of experience or as an LPN with 5+ years of experience.
• Preferred experience in Med‑Surg, Case Management, and/or Discharge Planning.
• 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.

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
• 401K
• EEO

, #INDMA

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