Remote Oncology Utilization Review Case Manager (Non-RN)

University of Miami; United States; Remote; USD 65,000 - 90,000; Full time

Benefits offered by this job

Comprehensive benefits

Tuition remission

Job summary

University of Miami Health System seeks a full-time Utilization Review Case Manager to work remotely. The role reviews patient charts for prior authorization, concurrent and retrospective utilization, coordinating with the care team for timely and appropriate care.

You will manage a caseload, communicate with clinicians and patients, and help minimize delays and denials. Qualifications include a bachelor’s degree and at least 2 years of relevant experience; oncology experience is preferred.

Qualifications

• Bachelor’s degree in relevant field; or equivalent.
• Minimum of 2 years of relevant experience.
• Oncology - Preferred.
• Any relevant education, certifications and/or work experience may be considered.

Responsibilities

• Perform initial, concurrent and retrospective chart reviews for clinical utilization and authorization.
• Coordinate with the healthcare team to prevent delays and denials.
• Communicate progress and determinations to clinical teams and patients.
• Monitor a designated patient caseload and facilitate for best outcomes.
• Serve as a liaison between patient/family, healthcare personnel and insurers.
• Stay informed on payer policies and guidelines to support appropriate utilization.

Skills

Communication skills

Care coordination

Chart review

Education

Bachelor’s degree in relevant field

Job description

University of Miami Health System seeks a full-time Utilization Review Case Manager to work remotely. The role reviews patient charts for prior authorization, concurrent and retrospective utilization, coordinating with the care team for timely and appropriate care.

You will manage a caseload, communicate with clinicians and patients, and help minimize delays and denials. Qualifications include a bachelor’s degree and at least 2 years of relevant experience; oncology experience is preferred.