Demo

Utilization Management RN

VITALCARE MEDICAL PRACTICE
Dover, DE Full Time
POSTED ON 1/6/2026
AVAILABLE BEFORE 2/4/2026
VitalCore Health Strategies, (VCHS), an industry leader in Correctional Healthcare, has an opening for a Utilization Management RN at the Regional Office in Dover, Delaware!!!

Start A New Career with VitalCore Health Strategies!

At VitalCore we pride ourselves on retaining and acquiring hardworking ethical individuals who are committed to providing quality services. Join our team and experience first-hand how VitalCore Health Strategies promotes a positive work environment that is based on respect and appreciation of the hard work and dedication of our staff.

Utilization Management Rn Benefits Package

Holiday Pay: New Year’s Day, Martin Luther King Jr. Day, Memorial Day, Juneteenth, Independence Day, Labor Day, Veteran’s Day, Thanksgiving Day, and Christmas DayMedical/Dental/Vision InsuranceLife InsuranceShort Term/Long Term DisabilityIdentity Theft ProtectionAnimal/Pet InsuranceEmployee Assistance Program and Discount Center401KEEO PTO Annual Incentive BonusUTILIZATION MANAGEMENT RN - ESSENTIAL FUNCTIONS

Essentially will serve as a Regional Office Case Manager for an incarcerated population, advocating for optimum healthcareMaintain accurate, detailed reports and confidential records Be familiar with all roles and tasks within the utilization management division, including cross-training in all areas. Provide coverage in the absence of the UM Director, or as requested. Complete both Medicaid and Reentry (as requested) assist applications processes.Track and log tasks as directed by UM Director utilizing SharePoint, TEAMS, excel etc. Facilitate Care Management call daily with site leadership, maintain Care Management log daily. Maintain Emergency Room Inpatient (ERIP) log and submit daily. Facilitate Grand Rounds with providers daily and maintain tracking log. In conjunction with the Regional Chief Nursing Officer, assist in the transition of acute or complex offenders from the hospital back to the various sites. Multi-task various utilization management tasks, while being available to assist others as needed or requested. Assist in the education of VitalCore employees as needed or requested regarding VitalCore's utilization management processes, purpose and goals. Professionally and positively greet and interact with the DOC (client), VitalCore employees, community partners and any regional office visitors. Rotate/share the end of the month responsibilities related to offenders admitted to a hospital on the last day of the month. Attend any meetings required or requested by VitalCore leadership.Additional duties as assigned by regional officeUTILIZATION MANAGEMENT RN MINIMUM REQUIREMENTS / PREFERENCES

Graduate of an accredited School of NursingLicensure as a Registered Nurse in the state of employment (or compact license)Possesses an active CPR certificationRemains knowledgeable about specific state laws and regulations governing practiceSatisfactory completion of initial and annual clinical competencies to demonstrate aptitude as assigned by role

We’re people who are fueled by passion, not by profit.

Keywords: Utilization Management, RN, Nurse, Administrative

Full-Time, 40/hrs week

PI281117427

Salary.com Estimation for Utilization Management RN in Dover, DE
$86,163 to $107,078
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