UTILIZATION REVIEW SPECIALIST, SENIOR - UTILIZATION/DENIALS MANAGEMENT

Location
Varies, Riverview, FL
Salary
Competitive
Posted
11/14/2017
Closes
11/16/2017
Specialty
Managed Care
Contract Type
Permanent
Hours
Full Time
 
 

 

BayCare Health System currently consists of 14 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and physician offices, all located throughout the Tampa Bay area. We're committed to delivering the highest quality, compassionate care to all those we serve. That's why we attract forward-thinking people who are enthusiastic about the future. And you can be sure we'll give you what you need to succeed - both personally and professionally.

 


The Senior Utilization Review Specialist functions as the primary liaison between the funding agents and all other related parties to ensure appropriate level of care through comprehensive concurrent review for medical necessity of outpatient observation and inpatient stays and the utilization of ancillary services. The Senior Utilization Review Specialist is responsible for the oversight of the utilization Review Specialists. Perform other duties as assigned by the supervisor.

Qualifications
Certifications and Licensures
Required | RN (Registered Nurse)
Preferred | Utilization Management
Preferred | Case Manager

Education
Required | Associate's | Nursing
Or | Diploma | Nursing
Preferred | Bachelor's | Nursing

Experience
Required | 1 year | Utilization Review
Or | 3 years | Registered Nurse

Specific Skills
Required | Customer service skills
Required | Written and verbal communication skills
Required | Interpersonal skills
Required | Work with a team
Required | Critical thinking skills
Required | Knowledge of regulatory standards appropriate to position
Required | Work independently
Required | Delegation skills
Required | Computer skills appropriate to position
Required | Organizational skills

 
   

Come be part of our high-energy workplace, and take advantage of our generous benefits, career development opportunities, continuing education programs and internal mobility options. Join us here and you'll always find new reasons to love where you work and who you are.

www.BayCareJobs.com
866-221-3222

Equal Opportunity Employer. Drug-Free Workplace.