Utilization Management Case Manager

Lee Health; Fort Myers (FL); Remote; USD 42,000 - 56,000; Full time

Job summary

Lee Health is hiring for a Utilization Management RN position. This remote role begins onsite for the first 90 days and requires licensure in Florida. The nurse will perform utilization management duties, ensure regulatory compliance, and document care accurately while maintaining productivity and quality standards.

Experience in acute care and familiarity with peds is a plus. The role supports a corporate utilization management department and may involve weekend coverage as needed.

Qualifications

• Registered nurse licensed in Florida; BSN preferred.
• Minimum 3 years acute care hospital or equivalent utilization management experience.
• Case management certification preferred; ACM/ CCM/ CMCN/NACCM are a plus.

Responsibilities

• Perform utilization management functions to ensure regulatory compliance and medical necessity.
• Facilitate concurrent documentation reflecting care and resources used.
• Meet productivity and accuracy goals across utilization management processes.

Skills

Communication skills

Interpersonal skills

Analytical skills

Grammar and spelling

Multi-tasking

Basic computer skills

Education

Graduate of accredited nursing program

BSN preferred

BS in related healthcare field preferred

Job description

Location:Orion Building -6630 Orion DriveFort Myers FL 33912

Department: Utilization Management - Corporate

Work Type: Full Time

Shift: Shift 1/7:00:00AM to 3:30:00PM

Minimum to Midpoint Pay Rate:$30.27 - $40.86 / hour

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.

US:FL:Fort Myers