Clinical Utilization Specialist

7 days ago


Largo, Florida, United States BayCare Health System Full time
About the Role

At BayCare Health System, we are proud to be one of the largest employers in the Tampa Bay area. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. With the support of more than 30,000 team members, we promote a forward-thinking philosophy that's built on a foundation of trust, dignity, respect, responsibility and clinical excellence.

Key Responsibilities
  • Coordinates the appropriateness of healthcare utilization and ensures the completeness of admission documentation.
  • Communicates and educates staff regarding healthcare utilization and paperwork issues.
  • One Utilization Reviewer will be responsible for a minimum of 100 Medicare Admissions per month.
Position Details
  • Location: Hybrid - Orientation in BayCare Health System's Homecare Branch in Sarasota, FL (full-time for the first month) - After orientation, hybrid schedule - home office/Sarasota.
  • Status: Full-time - 40 hours per week.
  • Schedule: Monday - Friday 8:00 AM - 5:00 PM.
  • Weekend requirement: occasional.
  • On Call: No.
Certifications and Licensures
  • Required RN License - Florida.
  • Preferred Case Management Certification.
Education
  • Required associate's degree in nursing.
Experience
  • Required Case Management - one year.
  • Required Home Care - one year.
Benefits
  • Benefits (Health, Dental, Vision).
  • Paid time off.
  • Tuition reimbursement.
  • 401k match and additional yearly contribution.
  • Yearly performance appraisals and team award bonus.
  • Community discounts and more.


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