VITALCARE MEDICAL PRACTICE
Utilization Management RN
Join to apply for the Utilization Management RN role at VITALCARE MEDICAL PRACTICE.
VitalCore Health Strategies (VCHS), an industry leader in Correctional Healthcare, has an opening for a Utilization Management RN at the Regional Office in Dover, Delaware.
Benefits Package
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
401KEEO PTO Annual Incentive Bonus
Essential Functions
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 VitalCore employees as needed or requested regarding VitalCore's utilization management processes, purpose and goals.
Professionally and positively greet and interact with the DOC (client), VitalCore 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 VitalCore leadership. Additional duties as assigned by regional office.
Minimum Requirements / Preferences
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.
Job Details
Full‑Time, 40‑hour week.
Entry Level.
Salary: $71,100.00‑$97,800.00 (Delaware).
Keywords: Utilization Management, RN, Nurse, Administrative.
PI281117427
#J-18808-Ljbffr
VitalCore Health Strategies (VCHS), an industry leader in Correctional Healthcare, has an opening for a Utilization Management RN at the Regional Office in Dover, Delaware.
Benefits Package
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
401KEEO PTO Annual Incentive Bonus
Essential Functions
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 VitalCore employees as needed or requested regarding VitalCore's utilization management processes, purpose and goals.
Professionally and positively greet and interact with the DOC (client), VitalCore 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 VitalCore leadership. Additional duties as assigned by regional office.
Minimum Requirements / Preferences
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.
Job Details
Full‑Time, 40‑hour week.
Entry Level.
Salary: $71,100.00‑$97,800.00 (Delaware).
Keywords: Utilization Management, RN, Nurse, Administrative.
PI281117427
#J-18808-Ljbffr