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Utilization Management RN
1 day ago
Our promise to you:
Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.
All the benefits and perks you need for you and your family:
- Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance
- Paid Time Off from Day One
- 403-B Retirement Plan
- 4 Weeks 100% Paid Parental Leave
- Career Development
- Whole Person Well-being Resources
- Mental Health Resources and Support
- Pet Benefits
Schedule:
Full time
Shift:
Day (United States of America)
Address:
900 HOPE WAY
City:
ALTAMONTE SPRINGS
State:
Florida
Postal Code:
32714
Job Description:
- Monitor admissions and perform initial and continued stay medical necessity reviews.
- Maintain thorough knowledge of payer guidelines and regulatory requirements and manages concurrent and pre-bill denials to prevent loss of reimbursement.
- Collaborate and communicate with the multidisciplinary care team regarding patient status and concurrent denials.
- Build relationships to promote interdisciplinary collaboration.
- Ensure requested clinical information is communicated, monitors daily discharge reports, and follows up with insurance carriers to obtain complete authorization.
- Other duties as assigned.
The expertise and experiences you'll need to succeed:
QUALIFICATION REQUIREMENTS:
Associate's of Nursing (Required), Bachelor's of NursingAccredited Case Manager (ACM) - EV Accredited Issuing Body, Certified Case Manager (CCM) - EV Accredited Issuing Body, Registered Nurse (RN) - EV Accredited Issuing Body
Pay Range:
$68, $119,520.35
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.
