Registered Nurse - Utilization Management

Compass Government Solutions is a Woman Owned Small Business serving those who have served our nation and is committed to excellence in our daily practices. At Compass Government Solutions (CGS), our employees are our most valuable piece of the puzzle.

CGS is currently seeking a Registered Nurse - Utilization Management to provide services at the Seymour Johnson Air Force Base in Goldsboro, NC. In preparation to bid on this contract, we are seeking qualified candidates willing to be included in our proposal as interested and skilled individuals.

• Supports a comprehensive MTF Utilization Management plan/program as prescribed in the DoD Medical Management Guide and at the direction of the MTF Utilization Management Director.

• Actively and retrospectively reviews medical cases to confirm receipt of appropriate care, monitor for patterns/trends and develop action plan for areas requiring improvement.

• Reports on utilization patterns; briefs provider staff and executive staff.

• Maintains reports on which cases have been denied or received reduced third party payments and reports provider profiles to the MTF management for corrective action.

• Participates on multi-disciplinary teams to resolve recurring problems in the healthcare delivery process for care within or outside the MTF including referrals.

• Must be a U.S. Citizen

• Degree: Associates Degree of Nursing from a college or university accredited by Accreditation Commission for Education in Nursing (ACEN), the Commission on Collegiate Nursing Education (CCNE).

• At least three (3) years within the last four (4) years as a registered nurse in utilization management.

• Licensure: Current, full, active, and unrestricted license to practice as a registered nurse.



Certifications:

• Basic Life Support (BLS)

• Certified/certification eligible in relevant specialty, such as Certified Managed Care Nurse through the American Board of Managed Care Nurses or Certified Informatics Nursing, Ambulatory Care Nursing, Medical-Surgical Nursing or Nursing Case Management through the American Nurses Credentialing Center.

Benefits

• Competitive Salary 
• Accrued paid time off 
• Paid Federal Holidays 
• Health and Wellness benefits to help cover medical costs 
• Dental and Vision Plans 
• 401k Plan
• EOE AA M/F/Vet/Disability

All your information will be kept confidential according to EEO guidelines.