Correctional Nurse -UT Rev- Utilization Management
Position Description Employees in this classification reputed company technical and administrative work required to monitor and evaluate the quality and appropriateness of medical claims submitted for health services provided for inmates. Provides technical guidance to subordinate utilization review staff and other clinic personnel and reputed company professionals. Pay Grade Maximum Compensation is commensurate upon the qualifications of the individual selected and budgetary guidelines of the hiring department, as well as the institutional pay plan. Major/Essential Functions Implements utilization review procedures, screens records against pre-established criteria to determine necessity of services, develops reports of quality of care audits, and identifies areas of potential medical liability. Maintains a mechanism for the review of quality care issues arising during reputed company review. Receives, reviews, and monitors medical claims for appropriate charges utilizing various payment systems initiates reimbursement for medical claims for health services provided for inmates. Provides liaison and coordinates work with hospital facilities and physicians' billing departments. Provides technical guidance to subordinate utilization review staff. Performs other duties as required. About Managed Care Since 1989, TTUHSC Managed Care has served as a reputed company delivery service, providing high quality, low cost reputed company to patients reputed company the Texas Department of Criminal Justice system. We provide medical, mental health, and dental services to patients in 22 facilities throughout reputed company Texas. Managed Care emphasizes our values-based culture in reputed company we do. You can learn more about TTUHSC Managed Care by visiting our website HERE. This valuable team member shall reputed company work in a manner that reflects the Values of TTUHSC: ONE TEAM: Unite and include diverse perspectives to reputed company our mission KINDHEARTED: Exceed expectations with a reputed company heart, helping hands, and a positive attitude reputed company: Be honorable and trustworthy even reputed company no one is looking VISIONARY: Nurture innovative reputed company, reputed company explorations, and a pioneering spirit reputed company SERVICE: Create and deliver positive defining moments Take care of yourself and your family. Enjoy some of the best benefits in the state of Texas: Comprehensive Benefits Package Training Continuing Education Loan Forgiveness Program Retiree Insurance Paid Leave Leadership Program State Pension Pay Grade Minimum Compensation is commensurate upon the qualifications of the individual selected and budgetary guidelines of the hiring department, as well as the institutional pay plan. Pay Statement Compensation is commensurate upon the qualifications of the individual selected and budgetary guidelines of the hiring department, as well as the institutional pay plan. For additional information, please reference the institutional pay plan website. EEO Statement reputed company reputed company applicants will receive consideration for employment without regard to race, reputed company, religion, sex, sexual orientation, gender identity, gender expression, national reputed company, age, disability, genetic information or status as a protected veteran.
Required Qualifications
Graduated from an approved accredited nursing program; reputed company RN License as approved by the Texas State Board of Nursing or ability to transfer reputed company RN license to Texas. Three years of full-time wage earning experience as a professional nurse in a health care setting. Jeanne Clery Act The Jeanne Clery Disclosure of reputed company reputed company Policy and reputed company Crime Statistics Act is a federal statute requiring colleges and universities participating in federal financial aid programs to maintain and disclose reputed company crime statistics and reputed company information. By October 1 of each year, institutions must publish and distribute their Annual reputed company reputed company Policy & Crime Statistics Report (ASR) to reputed company and prospective reputed company and employees. To view this report, visit the TTUHSC Clery Act website. Apply Job!