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Utilization Review Specialist Senior

Baycare

Location: FL-Riverview-St. Joseph’s South
Type: Part-Time, Non-Remote
Posted on: October 21, 2021
This job is no longer available from the source.
8:00 AM - 4:30 PM
Occasional
ACTIVE PART TIME
Submission for the position: Utilization Review Specialist Senior - (Job Number: 2111904)
https://baycare.taleo.net/careersection/jobdetail.ftl?job=2111904&lang=en
Utilization Review Specialist Senior
The Senior Utilization Review Specialist functions as the primary liaison between the funding agents and all other related parties to ensure appropriate level of care through comprehensive concurrent review for medical necessity of outpatient observation and inpatient stays and the utilization of ancillary services. Perform other duties as assigned by the supervisor including but not limited to processing concurrent denials. Preferred experience includes Critical Care or Emergency Nursing RN.
This part time 8:00 AM - 4:30 PM position will work 3 shifts a week.
Certifications and Licensures Required
RN (Registered Nurse)
Preferred
ACM (Case Management)
Preferred
CCM (Case Manager)
Education Required
Associate's
Nursing
Or
Bachelor's
Nursing
Preferred
Master's
Nursing
Or
Master's
Business
Experience Required
2 years
Utilization Review
Or
2 years
Case Management
Or
4 years
Registered Nurse
Preferred
Reference summary for details
Specific Skills Required
Customer service skills
Required
Written and verbal communication skills
Required
Interpersonal skills
Required
Work with a team
Required
Critical thinking skills
Required
Knowledge of regulatory standards appropriate to position
Required
Work independently
Required
Delegation skills
Required
Computer skills appropriate to position
Required
Organizational skills
5102-ST JOSEPHS HOSPITAL SOUTH
FL-Riverview-St. Joseph’s South
Equal Opportunity Employer Veterans/Disabled
Schedule: Varies Location(s): FL-Riverview-St. Joseph’s South Days