Healthcare Utilization Specialist
1 week ago
Company Overview
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Ascension Sacred Heart Emerald Coast is a leading provider of high-quality healthcare to children and adults in South Alabama and Northwest Florida communities. Our faith-based ministry offers caregivers the opportunity to flourish personally and professionally in various specialties.
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Salary:
">We offer an estimated annual salary of $85,000 to $110,000 based on experience and qualifications.
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Job Description:
">As a Registered Nurse RN in our Utilization Review department, you will provide health care services regarding admissions, case management, discharge planning, and utilization review. Your responsibilities will include reviewing admissions and service requests for medical necessity and/or compliance with reimbursement policy criteria, providing case management and/or consultation for complex cases, and assisting departmental staff with issues related to coding, medical records/documentation, precertification, reimbursement, and claim denials/appeals.
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Required Skills and Qualifications:
">To be successful in this role, you must have a current Registered Nurse license from the Florida Board of Nursing or a compact state license, a diploma from an accredited school/college of nursing or required professional licensure at time of hire, and excellent communication and problem-solving skills.
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Benefits:
">We offer a comprehensive benefits package that includes paid time off (PTO), various health insurance options, retirement benefits, long-term and short-term disability, employee assistance programs, parental leave, adoption assistance, tuition reimbursement, and opportunities to give back to your community.
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Others:
">We are an equal employment opportunity employer and welcome applicants from diverse backgrounds. As a military-friendly organization, we promote career flexibility and offer many benefits to support the well-being of our military families, spouses, veterans, and reservists.
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