Regional Utilization Management Registered Nurse
NaphCare, Inc., Montgomery, AL, United States
Location
US-AL-Montgomery
Position Type
Full-Time
Category
Nursing
Overview
NaphCare Alabama Prisons LLC is hiring a Regional Utilization Management Registered Nurse for our Regional Office located in Montgomery, AL, where we manage all aspects of healthcare for individuals currently incarcerated in the Alabama Department of Corrections. As a Regional Utilization Management Registered Nurse you will work alongside correctional officers and other medical professionals who provide care to the individuals in residence. This is a unique position where you can make a difference to this diverse population of patients.
Responsibilities
Develop, implement, and administer the quality assurance and utilization review processes
Monitor and report on the quality of all facets of the medical care provided to patients
Perform utilization and concurrent review of patient cases
Conduct detailed clinical chart assessments
Gather clinical information to assess and expedite care needs
Determine need, if any, for intervention, and discussing with physicians
Reviews requests from providers regarding medical necessity of requested services for patients
Reviews and audits patients' medical records as indicated to determine medical necessity
Utilizes nationally recognized criteria to determine medical necessity of requested services
Refers provider requests to Medical Director or designee when medical necessity of requested services does not meet recognized criteria
Qualifications
A current and unrestricted RN license in AL
A minimum of 3 years’ experience in an acute care setting and 2 years’ experience in utilization review and/or case management
Valid BLS CPR card (AHA preferred)
Excellent communication and interpersonal skills
Attention to detail and decision‑making skills are essential
BSN or ADN required.
Some travel required
Why Join NaphCare?
NaphCare is one of the largest providers of healthcare services to correctional facilities throughout the US, and we are growing. If you have never considered a career in correctional healthcare, now may be the time! In addition to competitive salaries and generous employee benefits, we have opportunities for new graduates and experienced medical professionals, promote educational growth, and strongly support career advancement within the company.
Benefits for Full‑Time Employees Include:
Health, dental & vision insurance that starts day one!
Prescriptions free of charge through our health plan, beginning day one
Lowest Cost Benefits!
Employee Assistance Program (EAP) services
401K and Roth with company contribution that starts day one!
Tuition Assistance
Referral bonuses
Term life insurance at no cost to the employee
Generous paid time off & paid holidays
Free continuing education and CMEs
Equal Opportunity Employer
disability/veteran
#J-18808-Ljbffr
US-AL-Montgomery
Position Type
Full-Time
Category
Nursing
Overview
NaphCare Alabama Prisons LLC is hiring a Regional Utilization Management Registered Nurse for our Regional Office located in Montgomery, AL, where we manage all aspects of healthcare for individuals currently incarcerated in the Alabama Department of Corrections. As a Regional Utilization Management Registered Nurse you will work alongside correctional officers and other medical professionals who provide care to the individuals in residence. This is a unique position where you can make a difference to this diverse population of patients.
Responsibilities
Develop, implement, and administer the quality assurance and utilization review processes
Monitor and report on the quality of all facets of the medical care provided to patients
Perform utilization and concurrent review of patient cases
Conduct detailed clinical chart assessments
Gather clinical information to assess and expedite care needs
Determine need, if any, for intervention, and discussing with physicians
Reviews requests from providers regarding medical necessity of requested services for patients
Reviews and audits patients' medical records as indicated to determine medical necessity
Utilizes nationally recognized criteria to determine medical necessity of requested services
Refers provider requests to Medical Director or designee when medical necessity of requested services does not meet recognized criteria
Qualifications
A current and unrestricted RN license in AL
A minimum of 3 years’ experience in an acute care setting and 2 years’ experience in utilization review and/or case management
Valid BLS CPR card (AHA preferred)
Excellent communication and interpersonal skills
Attention to detail and decision‑making skills are essential
BSN or ADN required.
Some travel required
Why Join NaphCare?
NaphCare is one of the largest providers of healthcare services to correctional facilities throughout the US, and we are growing. If you have never considered a career in correctional healthcare, now may be the time! In addition to competitive salaries and generous employee benefits, we have opportunities for new graduates and experienced medical professionals, promote educational growth, and strongly support career advancement within the company.
Benefits for Full‑Time Employees Include:
Health, dental & vision insurance that starts day one!
Prescriptions free of charge through our health plan, beginning day one
Lowest Cost Benefits!
Employee Assistance Program (EAP) services
401K and Roth with company contribution that starts day one!
Tuition Assistance
Referral bonuses
Term life insurance at no cost to the employee
Generous paid time off & paid holidays
Free continuing education and CMEs
Equal Opportunity Employer
disability/veteran
#J-18808-Ljbffr