TEMPORARY UTILIZATION MANAGEMENT, LPN

Full-time employees will enjoy a competitive benefits package with options for you and your family including:

The compensation and benefits information is accurate as of the date of this posting. The Company reserves the right to modify this information at any time, with or without notice, subject to applicable law.

Equal Opportunity Employer

Are you looking for a career you can feel good about? We hire only those that strive to do their best. By joining our family, you'll receive the honor and recognition that comes with working for the industry's global leader in evidenced based rehabilitation.

Who We Are:

GEO provides complementary, turnkey solutions for numerous government partners worldwide across a spectrum of diversified correctional and community reentry services. From the development of state-of-the-art facilities and the provision of management services and evidence-based rehabilitation to the post-release reintegration and supervision of individuals in the community, GEO offers fully diversified, cost-effective services that deliver enhanced quality and improved outcomes.

Why Work for GEO:

• At GEO, we believe that diversity in our workforce and the inclusion of a variety of views, perspectives, and backgrounds are integral parts of our company's success.
• We believe that work is more than a place you go every day. It is about being inspired and motivated to achieve extraordinary things.
• Employee benefits play an important role in making The GEO Group a great place to work. At GEO, we believe in the three pillars of employee wellbeing: physical, emotional, and financial. With comprehensive benefits and competitive wages, we trust that you will find all the resources you need here to be successful.

Summary:

The Utilization Management Licensed Practical Nurse (LPN) role is to ensure that health care services are administered with quality, cost efficiency, and within compliance. The position will provide prospective, concurrent and retrospective reviews for incarcerated patients. Responsible for gathering clinical information on all patients presenting for admission/observation, while utilizing nursing skills for clinical appropriateness, and communicating in a timely manner with third party payors to establish ongoing authorization for patient care services. Also responsible for providing information, guidance and support to the correctional facility medical team relative to care coordination process and/or expectations, as well as acts as a liaison between providers and the facility medical management team in responses to appeals and grievances. Monitors Provider Network Management.

Primary Duties and Responsibilities:

• The Utilization Management Licensed Practical Nurse performs concurrent andretrospective reviews for clinical, financial, resource utilization. Coordinates with the Healthcare team to achieve optimal efficient outcomes, decreasing length of stay (LOS) and avoiding delays using MCG as the standard.
• Coordinates communication with physicians and identifies opportunities for expedited appeals and collaborates to resolve payer issues. Ensures/Maintains effective communication with TPA and other members of the healthcare team to ensure timely communication with providers.
• The Utilization Management Licensed Practical Nurse helps drive change by identifying areas of performance improvement (e.g., day-to-day workflow, process improvements, patient outcome) and Risk Management.
• Performs the review of requests for prior authorization of medical services, including diagnostic, outpatient care and services using defined criteria.
• The Utilization Management Licensed Practical Nurse identifies delays in treatment or appropriate utilization and serves as a resource, application of process improvement methodologies in evaluating outcomes of care.
• Accountable for a designated caseload and provides intervention and coordination to decrease avoidable delays.
• The Utilization Management Licensed Practical Nurse assists discharge planners in hospitals to develop an appropriate plan of care and locates most appropriate setting for incarcerated individuals requiring higher level of care.
• Serves as a clinical resource and liaison for site and hospital referral staff.
• The Utilization Management Licensed Practical Nurse coordinates patient's discharge planning needs with the correctional facility healthcare team.
• Maintains accurate records of all patients related interactions in CWQI.
• The Utilization Management Licensed Practical Nurse has the ability to stay organized and interact well with others in any situation.
• Monitors the Provider Network Management.
• The Utilization Management Licensed Practical Nurse provides daily updates to the Director of Utilization Management for review.
• Performs other duties as assigned.

Minimum Requirements

• Associate or bachelor's degree from an approved nursing program; graduate of an accredited school of nursing required.
• Must have a current, unrestricted license to practice as a Licensed Practical Nurse in the state of Florida.
• Two (2) years of Utilization management experience, MCG experience preferred.
• Two (2) years of clinical experience in medical/hospital setting preferred.
• Utilization Management or Case Management certification preferred.
• Experience using Microsoft Word, Excel, and medical management software.

The GEO Group, Inc.