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Clinical Care Coordinator

2 months ago


Miramar, Florida, United States Memorial Healthcare System Full time
Job Summary

We are seeking a highly skilled and experienced Registered Nurse to join our team as a Utilization Management RN. This role will be responsible for ensuring that patients receive the most appropriate level of care, while also managing the utilization of healthcare resources.

Key Responsibilities
  • Conduct thorough reviews of patient medical records to determine medical necessity for acute hospitalization
  • Use evidence-based medical necessity screening tools to complete initial and continued stay reviews
  • Communicate effectively with healthcare teams and other hospital-based interdisciplinary teams
  • Prepare statistical analysis and utilization review reports as necessary
  • Assist with issues related to coding, medical records/documentation, precertification, reimbursement, and claim denials/appeals
Requirements
  • Two (2) years of nursing experience
  • Registered Nurse Compact License (RN LICENSE COMPACT) - Compact RN Multistate, Registered Nurse License (RN LICENSE) - State of Florida (FL)
  • Critical thinking skills, effective communication skills, decisive judgment, and the ability to work with minimal supervision
  • Knowledge of medical literature, research methodology, and financial/reimbursement issues
  • Ability to work collaboratively and proactively with healthcare teams and other hospital-based interdisciplinary teams
Working Conditions

This role requires the ability to work in a fast-paced environment, with a high level of accuracy and attention to detail. The successful candidate will be able to work effectively in a team environment, with minimal supervision.

What We Offer

As a Utilization Management RN with Memorial Healthcare System, you will have the opportunity to work with a talented team of healthcare professionals, while also contributing to the delivery of high-quality patient care. We offer a competitive salary and benefits package, as well as opportunities for professional growth and development.