Talent.com
Utilization Review Staff Job ID-1638446

Utilization Review Staff Job ID-1638446

North Shore Medical CenterMiami, FL, USA
1 day ago
Job type
  • Full-time
  • Part-time
  • Quick Apply
Job description

We are North Shore Medical Center

Our primary function is to offer continuous nursing, medical, and other health and social services on a 24-hour basis, under physician-directed care and RN supervision.

We service a multitude of patients and their families across our vast network, while remaining committed to the professional development of our staff, the functional improvement of our patients, and the cultivation of strong partnerships within our communities.

WHAT WE OFFER

  • An essential / stable and growing company with many opportunities for training and advancement within the medical field that all employees and team members (including Full-Time and Part-Time) can benefit from.
  • Hourly pay is negotiable based on experience.
  • Comprehensive Employee Benefits : Full-Time employees are eligible for various plans for medical, dental, and vision insurance.

PRIMARY RESPONSIBILITIES

  • Conduct thorough reviews of clinical documentation to determine the medical necessity of services rendered.
  • Analyze data related to patient care and outcomes to identify areas for improvement.
  • Provide support in the development of clinical guidelines and protocols for utilization management.
  • Maintain up-to-date knowledge of medical terminology, coding (CPT, ICD-9, ICD-10), and healthcare regulations.
  • Engage in discharge planning and case management to facilitate patient transitions.

    • Skills

  • Conduct thorough reviews of clinical documentation to determine the medical necessity of services rendered.
  • Analyze data related to patient care and outcomes to identify areas for improvement.
  • Provide support in the development of clinical guidelines and protocols for utilization management.
  • Maintain up-to-date knowledge of medical terminology, coding (CPT, ICD-9, ICD-10), and healthcare regulations.
  • Engage in discharge planning and case management to facilitate patient transitions.

    • Education & Requirements

  • Experience in Utilization Management
  • Previous experience working in Acute Care, or Behavioral health
  • Ability to Communicate in English
  • BLS required

    • We are committed to creating :

    A safe and respectful work environment . We want our team members to enjoy the same sense of care and belonging that we provide for our patients.

    Teams that celebrate, empower, and uplift people. A supportive, inclusive culture, where people flourish and thrive is one that everyone embraces and deserves.

    A culture of inclusivity and kindness . Don't just treat people how you want to be treated : treat them how they want to be treated. We believe, "If you can be anything in this world, be kind".

    Must be able to pass Background and Drug Test screenings.

    Create a job alert for this search

    Utilization Review • Miami, FL, USA