Utilization Case Manager (h)

University of Miami

Miami, FL, United States
Clinical utilization reviews
Continued authorization identification
Patient caseload accountability
The incumbent is to complete ongoing reviews for clinical utilization and identifying the need for continued authorization

Job Summary

  • The incumbent is to complete ongoing reviews for clinical utilization and identifying the need for continued authorization.
  • The Utilization Case Manager coordinates with the Nurse Case Manager as well as the Healthcare team for optimal patient outcomes, while avoiding potential treatment delays and authorization denials.
  • The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more.

Matching Summary

The incumbent is to complete ongoing reviews for clinical utilization and identifying the need for continued authorization.

Skills & Requirements

Must-have

  • clinical utilization reviews
  • continued authorization identification
  • patient caseload accountability
  • payer reimbursement policies knowledge
  • clinical guidelines adherence

Nice-to-have

  • proactive communication skills
  • interdepartmental collaboration
  • academic medical center environment

Key Requirements

  • Bachelor's degree or equivalent
  • Minimum of 2 years relevant experience

Work Rights

Not specified

Tailored Resume

Cover Letter