Registered Nurse Utilization Review, Case Management, Per Diem, 8A-4:30P
4 weeks ago
Baptist Health South Florida is the largest healthcare organization in the region, with 12 hospitals, more than 24,000 employees, 4,000 physicians and 100 outpatient centers, urgent care facilities and physician practices spanning across Miami-Dade, Monroe, Broward and Palm Beach counties.
A not-for-profit organization supported by philanthropy and committed to its faith-based charitable mission of medical excellence, Baptist Health has been recognized by Fortune as one of the 100 Best Companies to Work For in America and by Ethisphere as one of the World's Most Ethical Companies.
Everything we do at Baptist Health, we do to the best of our ability. That includes supporting our team with extensive training programs, millions of dollars in tuition assistance, comprehensive benefits and more. Working within our award-winning culture means getting the respect and support you need to do your best work ever. Find out why we're all in for helping you be your best.Description:
The purpose of this position is to conduct initial, concurrent, retrospective chart review for clinical, financial and resource utilization.
Coordinates with healthcare Team for optimal efficient patient outcomes, while decreasing length of stay and avoid delays and denied days.
They are accountable for a designated patient caseload and provides intervention and coordination to decrease avoidable delays denial of reimbursement.
Specific functions within this role include:
Screens pre-admission, admission process using established criteria for all points of entry; Facilitates communication between payers, review agencies and healthcare team; Identify delays in treatment or inappropriate utilization and serves as a resource; Coordinates communication with physicians; Identify opportunities for expedited appeals and collaborates resolve payer issues and ensures, maintains effective communication with Revenue Cycle Departments.
Estimated pay range for this position is $45.00 / hour depending on experienceQualifications:
Degrees:
Associates
Licenses & Certifications:
CCMC Case Manager
CDMS Certified Disability Management Specialist
Registered Nurse
ABMCM Certified Managed Care Nurse
McKesson Certified Professional in Utilization Management
AAMCN Utilization Review Professionals
RNCB Certified Rehabilitation Registered Nurse
ANCC Nursing Case Management
ACMA ACM Certification
NBCC Certification in Continuity of Care, Advanced
NACCM Care Manager Certified
Additional Qualifications:
RNs hired prior to 2/2012 with an Associates Degree in Nursing are not required to have a BSN to continue their non-leadership role as an RN, however, required to complete the BSN within 5 years of hire.
Minimum Required Experience:
3
EOE
-
Miami, Florida, United States Baptist Health South Florida Full timeBaptist Health South Florida is the region's largest not-for-profit healthcare organization with 12 hospitals, more than 27,000 employees, 4,000 physicians, and 200 outpatient centers, urgent care facilities, and physician practices spanning across Miami-Dade, Monroe, Broward, and Palm Beach counties. Baptist Health has internationally renowned centers of...
-
Miami, Florida, United States Baptist Health South Florida Full timeBaptist Health South Florida is the region's largest not-for-profit healthcare organization with 12 hospitals, more than 27,000 employees, 4,000 physicians, and 200 outpatient centers, urgent care facilities, and physician practices spanning across Miami-Dade, Monroe, Broward, and Palm Beach counties. Baptist Health has internationally renowned centers of...
-
Miami, Florida, United States Baptist Health South Florida Full timeBaptist Health South Florida is the region's largest not-for-profit healthcare organization with 12 hospitals, more than 27,000 employees, 4,000 physicians, and 200 outpatient centers, urgent care facilities, and physician practices spanning across Miami-Dade, Monroe, Broward, and Palm Beach counties. Baptist Health has internationally renowned centers of...
-
Miami, Florida, United States Jackson Health Full timeDepartment: Jackson Memorial Case Management, Utilization Review Address: 1611 NW 12 Ave, Miami, FL 33136Shift: Per Diem, Day Shift, 8 Hours (Local Remote)Why Jackson Memorial Hospital: Jackson Memorial Hospital is the flagship hospital for Jackson Health System and it has been a beacon of medical excellence and community care for more than a century....
-
Miami, Florida, United States Jackson Health Full timeDepartment: Jackson Memorial Case Management, Utilization Review Address: 1611 NW 12 Ave, Miami, FL 33136Shift: Per Diem, Day Shift, 8 Hours (Local Remote)Why Jackson Memorial Hospital: Jackson Memorial Hospital is the flagship hospital for Jackson Health System and it has been a beacon of medical excellence and community care for more than a century....
-
Miami, Florida, United States Baptist Health South Florida Full timeBaptist Health South Florida is the largest healthcare organization in the region, with 12 hospitals, more than 24,000 employees, 4,000 physicians and 100 outpatient centers, urgent care facilities and physician practices spanning across Miami-Dade, Monroe, Broward and Palm Beach counties. Baptist Health has internationally renowned centers of excellence in...
-
Miami, Florida, United States Baptist Health South Florida Full timeBaptist Health South Florida is the largest healthcare organization in the region, with 12 hospitals, more than 24,000 employees, 4,000 physicians and 100 outpatient centers, urgent care facilities and physician practices spanning across Miami-Dade, Monroe, Broward and Palm Beach counties. Baptist Health has internationally renowned centers of excellence in...
-
Miami, Florida, United States Baptist Health South Florida Full timeBaptist Health South Florida is the largest healthcare organization in the region, with 12 hospitals, more than 24,000 employees, 4,000 physicians and 100 outpatient centers, urgent care facilities and physician practices spanning across Miami-Dade, Monroe, Broward and Palm Beach counties. Baptist Health has internationally renowned centers of excellence in...
-
Miami, Florida, United States Baptist Health South Florida Full timeBaptist Health South Florida is the largest healthcare organization in the region, with 12 hospitals, more than 24,000 employees, 4,000 physicians and 100 outpatient centers, urgent care facilities and physician practices spanning across Miami-Dade, Monroe, Broward and Palm Beach counties. Baptist Health has internationally renowned centers of excellence in...
-
Miami, Florida, United States Baptist Health South Florida Full timeBaptist Health South Florida is the region's largest not-for-profit healthcare organization with 12 hospitals, more than 27,000 employees, 4,000 physicians, and 200 outpatient centers, urgent care facilities, and physician practices spanning across Miami-Dade, Monroe, Broward, and Palm Beach counties. Baptist Health has internationally renowned centers of...
-
Miami, Florida, United States Baptist Health South Florida Full timeBaptist Health South Florida is the region's largest not-for-profit healthcare organization with 12 hospitals, more than 27,000 employees, 4,000 physicians, and 200 outpatient centers, urgent care facilities, and physician practices spanning across Miami-Dade, Monroe, Broward, and Palm Beach counties. Baptist Health has internationally renowned centers of...
-
Miami, Florida, United States Baptist Health South Florida Full timeBaptist Health has a commitment to strengthening the compassionate care we provide. With the addition of Boca Raton Regional Hospital, Baptist Health is able to provide the Palm Beach community expanded access to healthcare services.Boca Raton Regional Hospital is an advanced tertiary medical center with 400 beds and is a recognized leader in Cardiovascular...
-
Miami, Florida, United States Baptist Health South Florida Full timeBaptist Health has a commitment to strengthening the compassionate care we provide. With the addition of Boca Raton Regional Hospital, Baptist Health is able to provide the Palm Beach community expanded access to healthcare services.Boca Raton Regional Hospital is an advanced tertiary medical center with 400 beds and is a recognized leader in Cardiovascular...
-
Miami, Florida, United States Jackson Health Full timeDepartment: Jackson Memorial Hospital - Utilization Review Case Management (two openings)Address: 1611 NW 12 Ave, Miami, FL 33136Shift Details: 8:00 am - 4:30 pm, Monday-Friday with weekends occasionally (primarily remote)Why Jackson Memorial Hospital: Jackson Memorial Hospital is the flagship hospital for Jackson Health System and it has been a beacon of...
-
Miami, Florida, United States Jackson Health Full timeDepartment: Jackson Memorial Hospital - Utilization Review Case Management (two openings)Address: 1611 NW 12 Ave, Miami, FL 33136Shift Details: 8:00 am - 4:30 pm, Monday-Friday with weekends occasionally (primarily remote)Why Jackson Memorial Hospital: Jackson Memorial Hospital is the flagship hospital for Jackson Health System and it has been a beacon of...
-
Miami, Florida, United States Baptist Health South Florida Full timeBaptist Health South Florida is the region's largest not-for-profit healthcare organization with 12 hospitals, more than 27,000 employees, 4,000 physicians, and 200 outpatient centers, urgent care facilities, and physician practices spanning across Miami-Dade, Monroe, Broward, and Palm Beach counties. Baptist Health has internationally renowned centers of...
-
Miami, Florida, United States Baptist Health South Florida Full timeBaptist Health South Florida is the region's largest not-for-profit healthcare organization with 12 hospitals, more than 27,000 employees, 4,000 physicians, and 200 outpatient centers, urgent care facilities, and physician practices spanning across Miami-Dade, Monroe, Broward, and Palm Beach counties. Baptist Health has internationally renowned centers of...
-
Miami, Florida, United States Baptist Health South Florida Full timeBaptist Health South Florida is the region's largest not-for-profit healthcare organization with 12 hospitals, more than 27,000 employees, 4,000 physicians, and 200 outpatient centers, urgent care facilities, and physician practices spanning across Miami-Dade, Monroe, Broward, and Palm Beach counties. Baptist Health has internationally renowned centers of...
-
Miami, Florida, United States Baptist Health South Florida Full timeBaptist Health South Florida is the region's largest not-for-profit healthcare organization with 12 hospitals, more than 27,000 employees, 4,000 physicians, and 200 outpatient centers, urgent care facilities, and physician practices spanning across Miami-Dade, Monroe, Broward, and Palm Beach counties. Baptist Health has internationally renowned centers of...
-
Miami, Florida, United States Baptist Health South Florida Full timeBaptist Health SouthFlorida is once again one of the 2020 Fortune 100 Best Companies to Work ForThis is the 20th time Baptist Health has been recognized on the list. We havealso been recognized for being among the best healthcare providers in the nationby U.S. News & World Reports in its Best Hospitals and have beenhonored as one of PEOPLE's Companies that...
