Utilization Management Case Manager

Summary

This is a remote position (first 90 days onsite) working one weekend day every 4th week. Peds experience a plus.

Performs utilization management functions that assure regulatory compliance, medical necessity and appropriate level of care. Facilitates concurrent documentation in the medical record to accurately reflect care, services and resources utilized in the delivery of patient care. Successfully meets requirements for productivity and accuracy related to all utilization management processes.

Requirements

Education: Graduate of an accredited school of professional nursing required. BSN or BS in a related healthcare field preferred.

Experience: Minimum of 3 years acute care hospital clinical experience or equivalent utilization management experience within 2 years with a focus on acute care.

Certification: Case Management certification, ACM, CCM, CMCN or NACCM preferred.

License: Currently licensed as an RN in the State of Florida.

Other: Communication and interpersonal skills, basic computer, analytical, grammar and spelling skills. Ability to effectively multi-task responsibilities.