Registered Nurse - Utilization Management bei Compass Government Solutions, LLC

Compass Government Solutions (CGS) is a Woman-Owned Small Business dedicated to serving those who have served our nation. We are committed to excellence in everything we do—and that starts with our people. At CGS, we believe our employees are the key to our success.

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.

Job Duties:

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

At Compass Government Solutions, we value our team and offer a comprehensive benefits package designed to support your health, well-being, and professional growth:

• Competitive Salary – Recognizing your skills and experience.
• Accrued Paid Time Off & Paid Federal Holidays – Balance work and life with time to recharge.
• Medical, Dental, and Vision Plans – Flexible coverage to meet your needs.
• Capital Services' CSI Benefits Packages – Our signature benefit offering enhanced coverage, mental health support, and specialized resources tailored to our employees’ unique needs.
• 401(k) Plan – Planning for your future has never been easier.
• Life & Disability Insurance – Protection and peace of mind for you and your family.

EOE AA M/F/Vet/Disability

Compass Government Solutions is an Equal Opportunity Employer. We provide equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status or any other characteristic protected by federal, state or local laws.