Registered Nurse - Case Manager TBI

Job Description

Job Description

Decypher is a leading integrator of professional, technology, and management solutions and services. We provide our services globally to Federal, Commercial, Local and State clients. Our employees are our most valuable asset and play an integral role in the success of Decypher and our clients. Working at Decypher is not a job, but a career where your talent and energy is respected, and you can personally make a difference. Decypher invites you to join our professional team.

DESCRIPTION

Decypher is seeking a Registered Nurse Case Manager / CAMO with heavy focus on Traumatic Brain Injury

RESPONSIBILITIES

• Develops and implements a comprehensive Utilization Management plan / program
• Performs data / metrics collection on identified program areas; analyzes and trends results, including over- and underutilization of healthcare resources
• Analyzes medical referrals / appointments and general hospital procedures and regulations by monitoring specialty care referrals for appropriateness, covered benefits, and authorized surgery / medical procedures, laboratory, radiology and pharmacy
• Reviews previous and present medical care practices for patterns; trends incidents of under-or over-utilization of resources incidental to providing medical care
• Acts as referral approval authority for designated referrals per local / AF / DoD / national guidance and standards.

This job description is not intended to be all inclusive. Therefore, the employee may be requested to perform other reasonable duties as assigned by the immediate supervisor or other management as required.

QUALIFICATIONS

Commission for Case Manager Certification Certified Case Manager (CCM)

Compensation$38.54 per hour

At Decypher we believe that equal opportunity fuels innovation by using the strengths of individual differences. Therefore, we strive to provide a welcoming and inclusive work environment. Decypher is fully committed to a program of equal opportunity for all applicants and employees and will actively carry out all federal and state regulations and executive orders. We apply our equal opportunity policy to all employment decisions.

This position is not authorized for remote / telework