Description
**You Matter**
- Make a difference every day in the lives of the underserved
- Join a mission driven organization with a people first culture
- Excellent career growth opportunities
**Join us and find a career that supports:**
- Caring for overlooked, underserved, and vulnerable patients
- Diversity, equity, inclusion, and belonging
- Autonomy in a warm team environment
- Growth and training
**Perks and Benefits**
In addition to comprehensive benefits including medical, dental, vision, paid time off, and 401k, we foster a work, life balance for team members and their family to support physical, mental, and financial wellbeing including:
- DailyPay, receive your money as you earn it!
- Tuition Assistance and dependent Scholarships
- Employee Assistance Program (EAP) including free counseling and health coaching
- Company paid life insurance
- Tax free Health Spending Accounts (HSA)
- Wellness program featuring fitness memberships and product discounts
- Preferred banking partnership and discounted rates for home and auto loans
*Eligibility for perks and benefits varies based on employee type and length of service.
**Why Us**
**Now is your moment to make a difference in the lives of the underserved.**
If there is one unifying characteristic of everyone on our team, it is the deep desire to make a difference by helping society's most vulnerable and often overlooked individuals. Every day we have the distinct honor and responsibility to show up with non-judgmental compassion to provide hope and healing to those who need it most. For those whose calling it is to serve others, now is your moment to join our mission to provide quality care to every patient with compassion, collaboration, and innovation, to live our mantra to "Always Do The Right Thing!", and to collectively do our part to heal the world, one patient at a time.
Wellpath sees hundreds of thousands of unique individuals in their facilities month over month and a very large percent of those individuals receive direct clinical care, which includes lives saved by Narcan.
We offer ongoing training and development opportunities for licensed and unlicensed healthcare team members, and have best in class clinical resources for training, education, and point of care support.
**How you make a difference**
The Utilization Management Nurse role involves providing clinical care coordination, utilizationmanagement,and care management activities on a daily basis, in accordance with relevant nursingstandards, state and federal regulations, and under the guidance of the Chief Medical Officer. The incumbentwill be responsible for ensuring compliance with all applicable nursing standards, state and federal rules andregulations, while delivering effective utilization management, support and care management services. Thejob requires the ability to provide nursing care coordination, utilize clinical decision-making skills, and ensureappropriate utilization of healthcare services while working collaboratively with a multidisciplinary team.
**Key Responsibilities**
Conducts utilization management activities through timely prospective, concurrent andretrospectivereview activities for appropriateness of level of care and length of stay, while managing medical costsand ensuring compliance with all relevant policies and practices.
Communicates effectively with hospital departments, answering Utilization Management Departmentcalls, and establishing rapport with billing, utilization management and medical records teams.
Assists Claims Analysis with billing procedures and communicates discharge needs to the Program Manager/Health Services Administrator for determination of appropriate action.
Utilizes data bases and reference lists for specific third-party vendors and correctional facility sites, attending management meetings as requested and contributing to team efforts.
Maintains technical knowledge through attending educational workshops, reviewing publications, utilizing initiative and independent judgment as required, and staying up to date with relevant Corporate and Utilization Management policies and practices.
**Qualifications & Requirements**
Education
Master's in Healthcare Administration or unrestricted, current RN license in state of practice
Experience
Two (2) years' clinical experience with Utilization Management experience
Previous correctional/detention facility experience
Licenses/Certifications
Must maintain all certifications, educational requirements, licensing, etc. for RN license
Current (and must maintain) lifesaving BLS certification through AHA
**Additional Details**
Master's in Healthcare Administration or unrestricted, current RN license required
**We are an Equal Employment Opportunity / Affirmative Action Employer**
We celebrate diversity and are committed to creating an inclusive environment for all employees.
**We encourage you to apply!** If you are excited about a role but your experience doesn't seem to align perfectly with every element of the job description, we encourage you to apply. You may be just the right candidate for this, or one of our many other roles.
Deadline to apply to this position is contingent upon applicant volume. Those positions located in Colorado will have a specific deadline posted in the job description.
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**Requisition** -24-165493-
**Location** -CA, Dublin-
**Facility** -CA Alameda Cty Facilities-
**Type** -Full-Time-
**Shift** -Night 8 hour-
**Recruiter : Full Name: First Last** -Stacy Arlie-
**Recruiter : Email** -
Compensation Information:
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Starting At: 0.0
Up To: 0.0
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