The Utilization Manager Registered Nurse will review cases and educate patients on appropriate care while managing health care costs for military dependents and retirees. The role involves working remotely to ensure clinical competency and adherence to contract requirements.
Provide program-wide clinical guidance across utilization management, case management, and quality domains. Lead quality committees and conduct peer-to-peer discussions to ensure high-quality care for veterans and military beneficiaries.
Coordinate patient care and scheduling between internal and community providers while managing medical records in VA systems. Provide professional customer service and administrative support to patients, families, and staff.
