Utilization Management Registered Nurse
Location: Paul Rein Detention Facility, BR CO, FL, Pompano Beach
Facility: Paul Rein Detention Facility, BR CO
Job Type: Regular Full-Time
Our UM Nurse will assist with analyses of medical necessity, level of care, care progression, and resource utilization.
- Graduation from an accredited School of Nursing
- Previous experience working with utilization management
- Computer data entry experience
- Current licensure as a Registered Nurse
- Utilizes nationally recognized evidence-based criteria to determine medical necessity of requested services, diagnostics, specialty care, or inpatient care.
- Refers provider requests when the requested services do not meet the recognized criteria.
- Coordinate with healthcare staff and providers to plan for discharge back to DOC institutions.
- Reviews information to determine the level of care or the medical necessity of any services requested by a provider.
- Reviews and audit inmate medical records to determine what services or procedures are medically necessary.
- The above responsibilities are a highlight of responsibilities and not a full list. Other responsibilities may be performed as assigned.