Clinical Utilization Manager RN

2 days ago


Naples, Florida, United States Pine Ridge Physicians Regional Health System Full time
Job Title: Clinical Utilization Manager RN

Pine Ridge Physicians Regional Health System is seeking a skilled Clinical Utilization Manager RN to join our team.

Job Summary:

The Clinical Utilization Manager RN will be responsible for analyzing medical necessity, acute care appropriateness, and efficiency of medical services and procedures in the hospital setting. This includes assessing medical necessity for admission to the hospital and continued stay, ensuring that services are appropriate and authorized, and documenting care to minimize the risk of denials after discharge.

Responsibilities:

  • Analyze medical necessity and acute care appropriateness of medical services and procedures
  • Assess medical necessity for admission to the hospital and continued stay
  • Ensure services are authorized and documented
  • Minimize the risk of denials after discharge

Requirements:

  • Must be a registered nurse with at least 2 years of clinical experience
  • Familiar with standard concepts, practices, and procedures within a particular field
  • Associates degree required, bachelors degree preferred

About Us:

Pine Ridge Physicians Regional Health System is a leading healthcare provider dedicated to delivering high-quality patient care. We are committed to fostering a collaborative and supportive work environment that promotes professional growth and development.



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