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AdventHealth

Utilization Management RN Remote

AdventHealth, Florida, New York, United States

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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. 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

Job Details

Schedule : Full time

Shift : Day

Address : 900 WINDERLEY PL, MAITLAND, Florida 32751

Job Description

Shift: Monday-Friday 8am-4:30pm, every 4th weekend, may vary based on business needs.

Schedule: Full Time Remote, applicant must live within a 50-mile radius or be a current employee within an AdventHealth region.

Monitor admissions and perform initial and continued stay medical necessity reviews.

Maintain thorough knowledge of payer guidelines and regulatory requirements and manage 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, monitor daily discharge reports, and follow up with insurance carriers to obtain complete authorization.

Qualifications

Associate's of Nursing (Required)

Bachelor's of Nursing

Accredited Case Manager (ACM) - EV Accredited Issuing Body

Certified Case Manager (CCM) - EV Accredited Issuing Body

Registered Nurse (RN) - EV Accredited Issuing Body

Pay Range $68,132.50 - $119,520.35

Equal Opportunity Employer

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

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