Healthcare Utilization Review Specialist
5 days ago
We are seeking a skilled Healthcare Utilization Review Specialist to join our team at Ascension Sacred Heart Emerald Coast. This is a rewarding opportunity to make a positive impact in the lives of our patients and their families.
Key Responsibilities:- Provide healthcare services regarding admissions, case management, discharge planning, and utilization review.
- Review admissions and service requests within assigned units for prospective, concurrent, and retrospective medical necessity and/or compliance with reimbursement policy criteria.
- Assist departmental staff with issues related to coding, medical records/documentation, precertification, reimbursement, and claim denials/appeals.
- Audit and assess discharge planning needs with healthcare team members.
- Prepare statistical analysis and utilization review reports as necessary.
- Licensure/Certification/Registration: A licensed Registered Nurse credentialed from the Florida Board of Nursing obtained prior to hire date or job transfer date required.
- Education: Diploma from an accredited school/college of nursing OR Required professional licensure at time of hire.
Ascension Sacred Heart 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 a variety of specialties.
Salary and Benefits:The estimated annual salary for this position is $75,000-$90,000 depending on experience and qualifications. Additionally, we offer a comprehensive benefits package including paid time off (PTO), various health insurance options & wellness plans, retirement benefits including employer match plans, long-term & short-term disability, employee assistance programs (EAP), parental leave & adoption assistance, tuition reimbursement, and ways to give back to your community.
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Healthcare Utilization Specialist
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Destin, Florida, United States Ascension Sacred Heart Emerald Coast Full timeCompany Overview"> ">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."> ">Salary:">We offer an estimated annual salary of...
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