Clinical Utilization Manager
3 weeks ago
We are seeking a highly skilled Clinical Utilization Manager to join our team at Spectrum Healthcare Resources. As a Clinical Utilization Manager, you will play a critical role in reviewing cases, educating patients on appropriate care, and managing healthcare costs for the dependents of our Nation's Active Duty and eligible retirees.
Responsibilities:
Review cases to ensure accurate and efficient care
Educate patients on appropriate care and management of healthcare costs
Collaborate with healthcare providers to ensure seamless care coordination
Develop and implement effective care plans to manage healthcare costs
Analyze data to identify trends and areas for improvement
Requirements:
Bachelors Nursing Degree
At least one active state nurse license, preferably compact state licensure
At least 2 years' experience working as an RNUM, preferably in a remote or hybrid environment
Possess current certification in either Completion of an accredited Certified Professional Utilization Review (CPUR) program or Certified Case Manager (CCM) issued by the Commission for Case Manager Certification
Work Schedule:
Monday - Friday, 8 hours a day, no nights and weekends
Company Overview:
Spectrum Healthcare Resources is a leading organization that provides physician and clinical staffing and management services to United States Military Treatment Facilities, VA clinics, and other Federal Agencies. We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.
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