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    Duties

    Summary

    This position will support the Federal Government's response efforts to COVID-19.
    This position is located in the Division of Quality Management, Utilization Management, Chinle, AZ. The primary purpose of this position is to serve as a Utilization Management Nurse/Compliance Officer. Incumbent will ensure the receipt of high quality, cost efficient medical outcomes for those enrollees identified as having the need for inpatient/outpatient treatment or overlong hospital stays.

    Learn more about this agency

    Responsibilities

    • Assess, plans, monitors, and evaluates patient care through utilization review.
    • Reviews and assesses inpatient and outpatient medical records.
    • Reviews and analyzes treatment records to evaluate quality necessity.
    • Identifies possible admission clinical discrepancies and discusses with attending physician.
    • Collaborates clinically with other healthcare professionals to ensure there is a process for the collection of utilization data.
    • Evaluates discharge planning and case management activities and conducts ongoing monitoring.
    • Prepares reports for dissemination during Inpatient Discharge Planning, Conferences.
    • Performs pre-admission, admission and continued stay review of elective, urgent, and emergency admissions.

    Travel Required

    Not required

    Supervisory status

    No

    Promotion Potential

    None

  • Job family (Series)

    0610 Nurse

This job originated on www.usajobs.gov. For the full announcement and to apply, visit www.usajobs.gov/GetJob/ViewDetails/566708400. Only resumes submitted according to the instructions on the job announcement listed at www.usajobs.gov will be considered.