Utilization Management Case Manager

Lee Health • Cape Coral, FL

3d • Onsite

About The Position

Performs utilization management functions to assure regulatory compliance, medical necessity, and appropriate level of care. Facilitates concurrent documentation in the medical record to accurately reflect the care, services, and resources used in delivering patient care. Successfully meets productivity and accuracy requirements for all utilization management processes.

Requirements

• Graduate of an accredited school of professional nursing.
• At least 3 years of acute care hospital clinical experience, or equivalent utilization management experience within the past 2 years with a focus on acute care.
• Currently licensed as an RN in the State of Florida.
• Communication and interpersonal skills.
• Basic computer, analytical, grammar, and spelling skills.
• Ability to effectively multitask responsibilities.

Nice To Haves

• BSN or BS in a related healthcare field.
• Case Management certification such as ACM, CCM, CMCN, or NACCM.

Responsibilities

• Assure regulatory compliance, medical necessity, and appropriate level of care through utilization management functions.
• Facilitate concurrent medical record documentation that accurately reflects care, services, and resources used in patient care.
• Meet productivity and accuracy requirements for utilization management processes.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level