Utilization Management Case Manager

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

Job summary

Lee Health in Fort Myers, FL is seeking a full-time Utilization Management RN to work onsite at Gulf Coast Medical Center from 8:00 AM to 8:00 PM, every other weekend. This role ensures regulatory compliance, medical necessity, and appropriate level of care through concurrent documentation and coordinated UM processes.

The ideal candidate has a Florida RN license, 3+ years of acute care or UM experience, and prefers BSN.

Qualifications

• Graduate of an accredited school of professional nursing; BSN preferred.
• Minimum 3 years acute care hospital clinical experience or equivalent utilization management experience.
• Case Management certification (ACM/ CCM/ CMCN/ NACCM) preferred.
• Currently licensed RN in Florida.
• Strong communication, interpersonal, analytical, and multi-tasking skills.

Responsibilities

• Perform utilization management to ensure regulatory compliance and appropriate level of care.
• Facilitate concurrent documentation in the medical record to reflect care and resources used.
• Meet productivity and accuracy requirements across UM processes.

Skills

Communication

Interpersonal skills

Analytical skills

Multitasking

Computer skills

Education

BSN

Job description

Location:Gulf Coast Medical Center -13681 Doctor's WayFort Myers FL 33912

Department: Utilization Management - Corporate

Work Type: Full Time

Shift: Shift 2/8:00:00AM to 8:00:00PM

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

Summary

This position is onsite from 8am to 8pm in the Emergency Department of Gulfcoast Medical Center working every other weekend.

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