Job Description
Overview:
NaphCare is hiring a PRN, Utilization Management - Nurse Practitioner NP to join our team of medical professionals at the Corporate office in Birmingham, AL.
As a Utilization Management - Nurse Practitioner NP, you will review clinical charts to evaluate the medical necessity and appropriateness of off-site specialty visits and also perform case management for hospitalized patients.
This is a unique position where you can make a difference to this diverse population of patients with complex medical needs.
Responsibilities:
Responsibilities for Utilization Management Nurse Practitioner (NP):
- Understanding of the principles and concepts of medical quality assurance and utilization review.
- 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 discuss with physicians.
- Reviews requests from providers regarding the 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 the medical necessity of requested services.
- Refers provider requests to the Medical Director or designee when the medical necessity of requested services does not meet recognized criteria.
Qualifications for Utilization Management Nurse Practitioner (NP):
- A current and unrestricted Nurse Practitioner license in Arizona
- A valid CPR card (AHA required)
- A minimum of 3-years experience in an acute care setting and 2 years' experience in utilization review and/or case management.
- Familiarity with Milliman or Interqual Care Guidelines is preferred
- Excellent communication and interpersonal skills
- Attention to detail and decision-making skills are essential
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.
NaphCare 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
If you would like to speak with me to learn more about this position and NaphCare, apply directly to the position to initiate the application process, and I’ll be in touch.
Equal Opportunity Employer: disability/veteran
Follow Us: Instagram | Facebook | LinkedIn | Advancing Correctional Healthcare | NaphCare
Numbers & Facts
| Location | Birmingham, Alabama |
| Job Type | Per diem |
| Industry | Healthcare Services |
| Company Size | 500 to 999 employees |
| Year Founded | 1989 |
| Website | http://www.naphcare.com/ |
About Company
NaphCare is dedicated to implementing cost-effective, quality services according to our clients' needs.
Because every facility is unique, we tailor our services to meet each client's respective needs. We deliver solutions based on your requests rather than telling you how to run your facility. NaphCare evaluates, evolves, and adapts our programs according to not only client needs, but also the ever-changing field of correctional healthcare.
When you choose NaphCare, you choose a proactive, preventive healthcare provider. We focus on a “Day One” mentality, providing care up front and without delay. Our clients experience greater efficiency, a reduction in unnecessary costs, and transfer their legal liability, all without giving up their independence. NaphCare is leading the way with an all-in-one approach to correctional healthcare that provides services unique to your facility.
Personal Attention
With NaphCare, people come first. We are proud of our company culture and ability to connect with our clients on a personal level, and it is NaphCare's mission to continue our history of personalized service. Care is not reserved simply for the patients entrusted to us, but also for our client partners. We care for our clients by providing efficient services to reduce their costs, communicating regularly about our services, listening to the client, providing accountability through continuous quality studies and reporting, and working with integrity at all times.
Company Consistency
Also, as an independent healthcare partner, we are free from complex partnerships and distant investors that limit our competitors' responsiveness. NaphCare has not undergone any corporate reorganization or restructuring since the company was founded in 1989, and has no plans to do so in the future. This stability, along with planned and structured growth, ensures that our client partners receive personal attention from our administrative and medical support team at our headquarters.
Financial Stability
NaphCare is a financially stable and fiscally responsible company. Throughout our history, we have maintained steady, measured growth, more stable than sweeping corporate changes. Our clients do not have to worry about drastic shifts in our company and how such changes will affect their services.
One of the best indicators of a company's financial stability is its ability to secure insurance and a bonding line. NaphCare is proud of our ability to provide performance bonds, rather than letters of credit. Due to our financial strength, NaphCare has exceptional insurance programs that indemnify our clients against litigation regarding healthcare services.
Because every facility is unique, we tailor our services to meet each client's respective needs. We deliver solutions based on your requests rather than telling you how to run your facility. NaphCare evaluates, evolves, and adapts our programs according to not only client needs, but also the ever-changing field of correctional healthcare.
When you choose NaphCare, you choose a proactive, preventive healthcare provider. We focus on a “Day One” mentality, providing care up front and without delay. Our clients experience greater efficiency, a reduction in unnecessary costs, and transfer their legal liability, all without giving up their independence. NaphCare is leading the way with an all-in-one approach to correctional healthcare that provides services unique to your facility.
Personal Attention
With NaphCare, people come first. We are proud of our company culture and ability to connect with our clients on a personal level, and it is NaphCare's mission to continue our history of personalized service. Care is not reserved simply for the patients entrusted to us, but also for our client partners. We care for our clients by providing efficient services to reduce their costs, communicating regularly about our services, listening to the client, providing accountability through continuous quality studies and reporting, and working with integrity at all times.
Company Consistency
Also, as an independent healthcare partner, we are free from complex partnerships and distant investors that limit our competitors' responsiveness. NaphCare has not undergone any corporate reorganization or restructuring since the company was founded in 1989, and has no plans to do so in the future. This stability, along with planned and structured growth, ensures that our client partners receive personal attention from our administrative and medical support team at our headquarters.
Financial Stability
NaphCare is a financially stable and fiscally responsible company. Throughout our history, we have maintained steady, measured growth, more stable than sweeping corporate changes. Our clients do not have to worry about drastic shifts in our company and how such changes will affect their services.
One of the best indicators of a company's financial stability is its ability to secure insurance and a bonding line. NaphCare is proud of our ability to provide performance bonds, rather than letters of credit. Due to our financial strength, NaphCare has exceptional insurance programs that indemnify our clients against litigation regarding healthcare services.
Skills
Level up your application
Professional resume templates
Browse dozens of recruiter approved resume templates, layouts and formats. Choose your favorite and make it your own in minutes.
Free resume templatesResume Builder
Improve your existing resume or start from scratch and create a standout, ATS-friendly resume. Add job-specific content, download and apply.
Resume Builder