Remote Oncology Utilization Case Manager

University of Miami; Miami (FL); A distancia; USD 70.000 - 90.000; Jornada completa

Descripción de la vacante

The University of Miami is seeking a remote Utilization Case Manager to conduct ongoing reviews for continued authorization and coordinate with the healthcare team to ensure optimal patient outcomes. This is a full-time staff position with a focus on timely authorization and interdepartmental communication.

Required qualifications include a Bachelor’s degree in a relevant field and at least two years of related experience.

Formación

• Bachelor’s degree in relevant field required.
• Minimum 2 years of relevant experience required.

Responsabilidades

• Adhere and perform timely reviews for services requiring an authorization for continuation of care.
• Follows the authorization process using established criteria as set forth by the payer or clinical guidelines.
• Accurate review of coverage benefits and limitations to determine continued appropriateness of services requested.
• Facilitates interdepartmental communication regarding status of continued authorization in advance of patient’s appointment.
• Maintains effective communication regarding authorization status and determination to the clinical team and on occasion the patient.
• Identifies potential delays in treatment by reviewing the treatment plan and proactively communicates with the healthcare team and/or patient.
• Maintains knowledge regarding payer reimbursement policies and clinical guidelines.
• Adheres to University and department level policies and procedures and safeguards University assets.

Educación

Bachelor’s degree in relevant field

Descripción del empleo

The University of Miami is seeking a remote Utilization Case Manager to conduct ongoing reviews for continued authorization and coordinate with the healthcare team to ensure optimal patient outcomes. This is a full-time staff position with a focus on timely authorization and interdepartmental communication.

Required qualifications include a Bachelor’s degree in a relevant field and at least two years of related experience.