Case Manager Utilization Review

Children's Diagnostic & Treatment Center (CDTC); Fort Lauderdale (FL); In loco; USD 65.000 - 90.000; Tempo pieno

Descrizione del lavoro

Broward Health in Fort Lauderdale, FL seeks a full-time Case Management professional to perform and monitor integrated concurrent utilization review and case referrals per approved Utilization Review Plans. The role collaborates with medical staff to obtain clinical documentation for review and optimal patient placement.

You will maintain contact with Managed Care and other third-party payors to ensure appropriate case management, leveraging your nursing background and utilization review

Competenze

• Requires nursing degree and RN licensure.
• Specialization in nursing from an accredited school.
• Two years of acute hospital utilization review experience or foreign medical graduate with utilization review experience.

Mansioni

• Performs and monitors integrated concurrent utilization review and case referrals per approved Utilization Review Plans.
• Collaborates with medical staff to secure necessary clinical documentation for review and optimal patient placement.
• Maintains contact with managed care and other payors to ensure appropriate case management.

Conoscenze

Utilization review

Case management

Nursing knowledge

Formazione

Associate degree

Nursing program specialization

Descrizione del lavoro

Broward Health Corporate Spectrum - Department: Case Management

Shift: Shift 1 (Days)

FTE: 1.000000 (Full-Time)

Req #34780

Summary:

Performs and monitors integrated concurrent utilization review and case referrals on patients consistent with the approved Utilization Review Plans. Works with medical and professional staff to obtain appropriate clinical documentation for review and optimal patient placement. Maintains contact with Managed Care and other third party payors to ensure appropriate case management.

Education:

Essential:

• Associate

Education specialization:

Essential:

• in a Nursing Program from an Accredited School of Nursing

Experience:

Essential:

• Two Years of acute hospital Utilization Review experience; or Foreign Medical Graduate with Utilization Review experience

Credentials:

Essential:

• Basic Life Support
• Registered Nurse-LIC

• Bonus Exclusions may apply in accordance with policy HR-004-026

Broward Health is proud to be an equal opportunity employer. Broward Health prohibits any policy or procedure which results in discrimination on the basis of race color national origin gender gender identity or gender expression pregnancy sexual orientation religion age disability military status genetic information or any other characteristic protected under applicable federal or state law.

At Broward Health the dedication and contributions of veterans are valued. Supporting the military community and giving back to those who served is a priority. Broward Health is proud to offer veteran's preference in the hiring process to eligible veterans and other individuals as defined by applicable law.