Utilization Review Nurse

3 weeks ago


Clearwater, United States BayCare Health System Full time

Why BayCare?

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.

Summary:

  • Responsible for performing utilization reviews on the front-end and-or retrospectively to ensure the best and most appropriate treatment, care or services are being provided.

  • Communicates and coordinates with providers and facilities to facilitate optimal care and treatment and-or to obtain needed medical records for completion of the retrospective review process.

Minimum Qualifications:

Education:

  • Associates Degree - Nursing

Credentials:

  • RN License

Experience:

  • 2 years - Case Management

  • 2 years - Utilization Review

  • Directly working for Medicare Advantage Plan - preferred

Facility:

BayCare Health System, Utilization Management-BHS

Location: Park Place

Status: Full Time, Exempt: Yes

Weekend Work: Occasional

On Call: No

How often will this team member be working remotely? Hybrid

Equal Opportunity Employer Veterans/Disabled

Position Utilization Review Nurse - Health Plan

Location Clearwater:Park Place | Clinical | Full Time

Req ID null



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