Director of UM, Prisons
NaphCare, Inc.
Summary
NaphCare is hiring a Director Of Utilization, Prisons to join our team at the Corporate Headquarters located in Birmingham, AL. NaphCare is a family owned, healthcare technology company that has been delivering high quality healthcare to correctional facilities across the nation for over 35 years.
Job description
Overview
NaphCare is hiring a Director Of Utilization, Prisons to join our team at the Corporate Headquarters located in Birmingham, AL. NaphCare is a family owned, healthcare technology company that has been delivering high quality healthcare to correctional facilities across the nation for over 35 years.
Responsibilities
- 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
- 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
Qualifications
- A current and unrestricted RN license
- A minimum of 6 years' experience in an acute care setting and 4 years' experience in utilization review and/or case management
- Excellent communication and interpersonal skills
- Attention to detail and decision-making skills are essential
- Valid CPR card
Requirements
- Current and unrestricted RN license
- Minimum of 6 years' experience in an acute care setting
- 4 years' experience in utilization review and/or case management
- Excellent communication and interpersonal skills
- Attention to detail and decision-making skills
- Valid CPR card
Benefits
- Prescriptions free of charge
- Health, Dental & Vision Insurance
- EAP Services
- 401K and Roth
- Tuition Assistance
- Referral Bonuses
- On-site Education
- Free Continuing Education
- Term Life Insurance
- Paid Time Off
- Paid Holidays
Company overview
NaphCare, Inc. is a leading provider of comprehensive healthcare services and technology solutions specifically designed for correctional facilities across the United States. Founded in 1989 and headquartered in Birmingham, Alabama, the company partners with local, state, and federal government agencies to deliver innovative healthcare, technology, and administrative solutions for the correctional system. As a family-owned company with 1,001-5,000 employees, NaphCare has pioneered several industry-first initiatives including the Proactive Care Model, TechCare® Electronic Health Record system, and STATCare telehealth services. The company offers a full spectrum of correctional healthcare services including medical and mental health care, pharmacy services, dialysis, medication-assisted treatment, and forensic services. NaphCare's mission focuses on improving and saving lives through excellence and innovation, with a commitment to treating every patient with dignity while preparing them for successful reentry into their communities. The company has established itself as an industry leader with one of the longest-running partnerships with the federal Bureau of Prisons and multiple facilities earning the prestigious NCCHC Pinnacle Award for excellence in correctional healthcare.