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RN Case Manager - Utilization Review

2021-09-19 USD 100 1000000 Contract 2021-10-19
  • Job Id:

  • Profession:

    Case Management
  • Hiring Organization:

  • Employment Type:

5810 Coral Ridge Drive, Suite 250 Coral Springs FL 33076 USA
customer support [+954-656-8600]
  • Specialty:

    Floor CM
  • 321 Main St.


    Cleveland, OH 44101ClevelandOH
  • Start date:

    call for details
  • Salary:

    call for details


Responsible for supporting the physician and interdisciplinary team in the provision of patient care by ensuring the appropriate level of care at the point of entry. The utilization review nurse will work on defined patient populations and is responsible for an initial clinical review at the point of patient entry to the inpatient care setting, this includes observation status. Will collaborate with other interdisciplinary team members to develop and participate in a systematic approach to denial management, and in so doing reduce organizational exposure to revenue loss. Actively participates in the denial management process; improve reimbursement by optimizing revenue recovery due to inappropriate level of care, failure to meet medical necessity, and/or severity of illness.

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More Info


Divisional Headquarters
Two Harbour Place
302 Knights Run Avenue
Suite 1025
Tampa, FL 33602
Phone: 813.418.3800
Toll Free: 1.866.727.4461
Fax: 813.418.2256