Job Information
BayCare Health System Utilization Review Specialist Senior in Winter Haven, United States
At BayCare, we are proud to be one of the largest employers in the Tampa Bay area. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. With the support of more than 30,000 team members, we promote a forward-thinking philosophy that’s built on a foundation of trust, dignity, respect, responsibility and clinical excellence.
The Utilization Review Specialist Senior responsibilities include:
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
Perform other duties as assigned by the supervisor including but not limited to processing concurrent denials.
Preferred experience includes Critical Care or Emergency Nursing RN.
Benefits:
Benefits (Health, Dental, Vision)
Paid time off
Tuition reimbursement
401k match and additional yearly contribution
Yearly performance appraisals and team award bonus
Community discounts and more
Position details:
Location: St Joseph's Hospital - Tampa, Florida
Status: Full time, 72 hours per pay period
Schedule: Week 1: five days, 8 hours
Week 2: four days, 8 hours
Weekend requirement: every 3rd weekend
On Call: No
Certifications and Licensures:
Required RN (Registered Nurse)
Preferred ACM (Case Management)
Preferred CCM (Case Manager)
Education:
Required Associates in Nursing or
Required Bachelors in Nursing
Preferred Masters in Nursing or Business
Experience:
Required 2 years in Utilization Review or
Required 2 years in Case Management or
Required 3 years Registered Nurse
Preferred experience in Critical Care or Emergency Service
Equal Opportunity Employer Veterans/Disabled
Position Utilization Review Specialist Senior
Location Winter Haven:Winter Haven | Clinical | Full Time
Req ID null