Role OverviewManages daily activities of Utilization Review Nurses and Case Management Extenders to ensure effective processes and successful completion of utilization management, payer communication, authorizations for care provided, and timely progression of care and discharge planning.
What You Will Do
Develops procedures for efficient utilization review program, maintains current knowledge of regulatory requirements, and leads performance improvement activities to identify opportunities for improvement.
Why It Might Be a Fit
Requires 5+ years of clinical experience and a minimum of 5 years experience in utilization management and/or case management, with a strong understanding of utilization management guidelines and performance improvement activities.
Requirements
- 5+ years of clinical experience
- 5+ years experience in utilization management and/or case management
- Licensed as a Registered Nurse in the state of Florida
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