Case Manager RN - Utilization Review

Alumni Network Job Board(27 days ago)

Miami, FLOnsiteFull TimeMedior$73,441 - $99,204 (estimated)Case Management

About this role

The Utilization Case Manager RN at UHealth conducts medical necessity chart reviews and identifies authorization needs to support timely, appropriate patient care. The role coordinates with clinical teams to optimize outcomes, prevent treatment delays, and communicates authorization status to stakeholders. The nurse also serves as a subject matter expert, providing support and education to the team.

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Required Skills

Prior Authorization
Utilization Review
Case Management
Patient Assessment
Medical Terminology
Care Coordination
Clinical Documentation
Communication
Teamwork
Technical Proficiency

Qualifications

BSN
RN License (Florida)
BLS (AHA)

About Alumni Network Job Board

miami.edu

The University of Miami is a private research university in Coral Gables, Florida, serving more than 16,000 students from around the world. It is a vibrant, diverse academic community focused on teaching and learning, the discovery of new knowledge through research, and service to the South Florida region and beyond. UM offers a wide range of undergraduate, graduate, and professional programs with an emphasis on interdisciplinary scholarship, innovation, and community engagement.

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