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SalaryAt BayCare, 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.
The Utilization Review Specialist Senior responsibilities include:
- 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.
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
Certifications and Licensures:
- Required RN (Registered Nurse)
- Preferred ACM (Case Management)
- Preferred CCM (Case Manager)
Education:
- Required Associates in Nursing or
- Required Bachelors in Nursing
- Preferred Masters in Nursing or Business
Experience:
- Required 2 years in Utilization Review OR
- Required 2 years in Case Management OR
- Required 3 years Registered Nurse
- Preferred experience Critical Care or Emergency Service
Facility:
BayCare Health System, Utilization and Denials Management
Location: Morton Plant Hospital
Status: Full Time, Exempt
Shift Hours: 8:00 AM - 4:30 PM
Shift: Days
Weekend Work: Every 3rd weekend.
On Call: No
How often will this team member be working remotely? Hybrid
Equal Opportunity Employer Veterans/Disabled
