Case Manager Rn - Utilization Review

University of Miami

Miami, FL, United States
Conduct initial chart reviews
Identify need for authorization
Coordinate with healthcare team
The purpose of the Utilization Case Manager RN is to conduct initial chart reviews for medical necessity and identify the need for authorization

Job Summary

  • The purpose of the Utilization Case Manager RN is to conduct initial chart reviews for medical necessity and identify the need for authorization.
  • They are accountable for a designated patient caseload and provide intervention and coordination to decrease avoidable delays.
  • The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more.

Matching Summary

The purpose of the Utilization Case Manager RN is to conduct initial chart reviews for medical necessity and identify the need for authorization.

Skills & Requirements

Must-have

  • Conduct initial chart reviews
  • Identify need for authorization
  • Coordinate with healthcare team
  • Provide communication of progress
  • Serve as subject matter expert

Nice-to-have

  • Learning Agility
  • Teamwork
  • Technical Proficiency
  • Communication skills

Key Requirements

  • Valid State of Florida RN license
  • Basic Life Support Certification (BLS)
  • Minimum 2 years of relevant experience
  • Minimum of one 1 year in Hospital Case Management/nursing
  • Bachelor’s degree (BSN)

Work Rights

Not specified

Tailored Resume

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