Registered Nurse, Utilization Management

Company DescriptionAspire Medical Staffing is a clinician owned and operated medical staffing company founded in 2011, contracting with Commercial and Federal medical agencies,facilities and schools. We believe in a collaborative effort with all patient care. Our medical teams always consist of support from team leaders and an efficient way to communicate and collaborate with everyone. Join Aspire Medical Staffing today to help service our Military and their families across the nation.Job DescriptionAspire Medical Staffing is looking for a Registered Nurse Utilization management to provide services at the Naval Hospital Pensacola, FLAssist in the design and implementation of activities to increase hospital staff involvement in and support of an active and coordinated Medical Management program. As a member of the Medical Management team, the HCW shall work in coordination with Case Management, Disease Management, Referral Management and other members of the healthcare team in order to assure the seamless delivery of care. All services shall be provided in accordance with Military Treatment Facility (MTF) policies and protocols.Incorporate utilization review activities using the generally accepted standards and criteria for determining medical necessity, appropriateness, and reasonableness when reviewing the quality, completeness, and adequacy of health care provided to individual patients and patient populations and subsequently with similar patient populations.Possess a valid driver’s license and a personal vehicle for use under the task order.Possess current certification in one (1) of the following: * Certified Professional Utilization Review (CPUR) from McKesson Health Solutions.Certified Professional Utilization Management (CPUM) from McKesson Health Solutions.Health Care Quality and Management Certification from American Board of Quality Assurance and Utilization Review Physicians (ABQAURP)Certified Professional in Healthcare Quality (CPHQ) from Healthcare Quality Certification Board (HQCB).Certified Case Manager (CCM) issued by the Commission for Case Manager Certification.Advanced Certification in Continuity of Care (ACCC) issued by the National Board for Certification in Continuity of Care.Nurse Case Manager (RN-NCM) issued by the American Nurses Credentialing Center.Care Manager Certified (CMC) issued by the National Academy of Certified Care Managers.ORPossess two (2) years of full-time broad based registered nurse experience in a utilization management review or a case management setting within the preceding five (5) years. Notwithstanding the aforementioned experience requirements, the HCWs must have pertinent clinical experience within the past two (2) years sufficient to demonstrate current clinical competency for the setting and procedures required by this contract.ANDGraduation from an accredited nursing educational program.Possess and maintain a current unrestricted license to practice as an RN in any one of the 50 States, the District of Columbia, the Commonwealth of Puerto Rico, Guam or the U.S. Virgin Islands.QualificationsPossess current certification in one (1) of the following: * Certified Professional Utilization Review (CPUR) from McKesson Health Solutions.Certified Professional Utilization Management (CPUM) from McKesson Health Solutions.Health Care Quality and Management Certification from American Board of Quality Assurance and Utilization Review Physicians (ABQAURP)Certified Professional in Healthcare Quality (CPHQ) from Healthcare Quality Certification Board (HQCB).Certified Case Manager (CCM) issued by the Commission for Case Manager Certification.Advanced Certification in Continuity of Care (ACCC) issued by the National Board for Certification in Continuity of Care.Nurse Case Manager (RN-NCM) issued by the American Nurses Credentialing Center.Care Manager Certified (CMC) issued by the National Academy of Certified Care Managers.ORPossess two (2) years of full-time broad based registered nurse experience in a utilization management review or a case management setting within the preceding five (5) years. Notwithstanding the aforementioned experience requirements, the HCWs must have pertinent clinical experience within the past two (2) years sufficient to demonstrate current clinical competency for the setting and procedures required by this contract.ANDGraduation from an accredited nursing educational program.Possess and maintain a current unrestricted license to practice as an RN in any one of the 50 States, the District of Columbia, the Commonwealth of Puerto Rico, Guam or the U.S. Virgin Islands.Additional InformationTo discuss rates and caseloads- APPLY TODAY! Submit your resume today or call Amanda Perez 210-426-0268  for more information. I look forward to hearing from you soon. www.aspiremedicalstaffing.com