Reef Systems Corp

Registered Nurse (RN) – Eglin AFB, FL

Reef Systems Corp  •  Onsite  •  2 days ago
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Job Description

Registered Nurse (RN) – Eglin AFB, FL

Background/Experience

  • Shall read, understand, speak, and write English fluently
  • Shall have knowledge, skills and computer literacy to interpret and apply medical care criteria, such as, but not limited to, InterQual or Milliman Ambulatory Care Guidelines or applicable DHA approved resource and referral and TRICARE guidelines
  • Shall have a minimum of two (2) years broad-based clinical nursing experience in either an inpatient or outpatient care setting within the last three (3) years
  • License must be valid and unrestricted. Contract personnel shall be in good standing, and under no clinical restrictions, with the licensure boards in all jurisdictions in which a license is held or has been held within the last ten (10) years.
  • Operational computer skills with general working knowledge of word processing, and Microsoft applications (including Windows, Word, Excel, Outlook)
  • General medical ethics, telephone etiquette, written/verbal/electronic communication, and customer service skills




The Registered Nurse will provide Referral Management (RM) activities include timely processing of Right of First Refusal (ROFR) requests, screening of specialty care referrals, sustaining up- to-date Specialty Clinic Booking Guidance, MTF Capabilities Report, ROFR Reports, maintaining up-to- date MTF/Managed Care Support Contract (MCSC) Memorandums of Understanding (MOUs), comply with Referral and Authorization Business rules, tracking, accounting, and resulting of referrals, and full use of RM information management systems. Individual will conduct reviews for medical necessity, preauthorization, medical appeals, collection and recovery from insurance carriers, and right of first refusal activities. The Registered Nurse will provide utilization management activities in the Referral Management Center.

Hours of Operation:

Contract performance requirements are governed by the contract. The Contractor shall provide qualified and trained personnel to cover the required hours of performance. The Contractor shall provide CP for conducting business Monday thru Friday, within the various facility’s operational duty hours of 7:00 AM to 4:00 PM, except for Federal holidays, when the Government MTF is closed due to local or national emergencies, administrative closings, or similar Government directed facility closings or family/down days.
Reef Systems Corp

About Reef Systems Corp

Founded in 2008, Reef Systems delivers professional and efficient solutions tailored for the federal government and commercial market sectors. Reef Systems is an Authorized CMMC Third-Party Assessment Organization (C3PAO) honored to assist Organizations Seeking Certification (OSCs) in their quest to continue supporting the federal government as members of the Defense Industrial Base (DIB). Our offerings include Cybersecurity training, CMMC, NIST Assessments, Cybersecurity consulting and remediation, ISO 27001 and ISO 9001 Audit Preparation services, among others.

Reef Systems also provides Human Performance Optimization, Technical and Administrative services and solutions to the DoD, VA, DHA and other agencies.

Industry
Consulting & Advisory
Company Size
51-200 employees
Headquarters
Cary, North Carolina
Year Founded
2008
Website
reef-sys.com
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