Utilization Management RN

VitalCore Health Strategies • Hopkinton, MA

1d

About The Position

VitalCore Health Strategies, (VCHS), an industry leader in Correctional Healthcare, has a Full-Time opening for a Utilization Management RN at the Regional Office in Hopkinton, MA!!!

Start A New Career with VitalCore Health Strategies!

At VitalCore we pride ourselves on retaining and acquiring hardworking ethical individuals who are committed to providing quality services. Join our team and experience first-hand how VitalCore Health Strategies promotes a positive work environment that is based on respect and appreciation of the hard work and dedication of our staff.

UTILIZATION MANAGEMENT RN - ESSENTIAL FUNCTIONS

Essentially will 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
Performing as a Liaison with all offsite providers, both specialty as well as hospitals
Review medical transports to Emergency Departments to ensure continuity of care
Overseeing hospitalized cases, to include reviewing daily clinicals and providing information to facility MD and team
Assisting with hospital discharge planning to ensure goals of care are met
Seeking infirmary level bed placement when care is needed on a higher level
Additional duties as assigned by regional office

Requirements

• 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
• 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

Nice To Haves

• Preferred experience in Med Surg, Case Management, and/or Discharge Planning

Responsibilities

• 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
• Performing as a Liaison with all offsite providers, both specialty as well as hospitals
• Review medical transports to Emergency Departments to ensure continuity of care
• Overseeing hospitalized cases, to include reviewing daily clinicals and providing information to facility MD and team
• Assisting with hospital discharge planning to ensure goals of care are met
• Seeking infirmary level bed placement when care is needed on a higher level
• Additional duties as assigned by regional office

Benefits

• 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

What This Job Offers

• Job Type: Full-time
• Education Level: No Education Listed
• Number of Employees: 251-500 employees