Clinical Utilization Review Specialist

4 weeks ago


Clearwater, United States BayCare Health System Full time
Why BayCare?

At BayCare Health System, we strive to be a leader in healthcare by providing exceptional patient care and promoting a culture of trust, dignity, respect, responsibility, and clinical excellence.

Summary:

As a Utilization Review Nurse, you will play a critical role in ensuring that patients receive the best and most appropriate treatment, care, or services. You will communicate and coordinate with providers and facilities to facilitate optimal care and treatment, and obtain needed medical records for completion of the retrospective review process.

Key Responsibilities:

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

Communicate and coordinate with providers and facilities to facilitate optimal care and treatment, and obtain needed medical records for completion of the retrospective review process.

Requirements:

Associates Degree - Nursing

RN License

2 years - Case Management

2 years - Utilization Review

Work Environment:

BayCare Health System, Utilization Management-BHS

Park Place

Work Schedule:

Full Time, Exempt: Yes

Occasional Weekend Work

No On Call

Hybrid Remote Work

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