Complexity of Work : Requires critical thinking skills, effective communication skills, decisive judgment, and the ability to work with minimal supervision. Current sound clinical knowledge; knowledge of medical literature, research methodology, and financial / reimbursement issues. Knowledge of CMS, commercial payer requirements and hospital financial / reimbursement processes. Ability to work collaboratively and proactively with healthcare teams and other hospital‐based interdisciplinary teams. Must be able to work in a stressful environment and take appropriate action. Required Work Experience : Two (2) years of nursing experience. One (1) year of experience in utilization management or case management preferred. Other Information : Certification in utilization management and / or case management preferred.
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Utilization Management Rn • Hollywood, Florida, United States