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Utilization Review Case Manager at University of Miami - ApplyBlast

Utilization Review Case Manager

University of Miami

23 days ago

3.8 on Glassdoor

Remote

Full Time

Medior

0 applicants

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About this role

The Utilization Review Case Manager conducts initial, concurrent, and retrospective chart reviews to ensure clinical utilization and authorization compliance. This role coordinates with the healthcare team to optimize patient outcomes, prevent treatment delays, and manage authorization denials. The incumbent acts as a liaison between patients, families, healthcare personnel, and insurers to facilitate the best possible care outcomes.

Responsibilities

Conduct initial, concurrent, and retrospective chart reviews for clinical utilization and authorization
Coordinate with healthcare teams to optimize patient outcomes and prevent treatment delays
Evaluate patient needs and facilitate appropriate care resources while ensuring payer compliance

Skills

About University of Miami

miami.edu

Headquarters

Miami, Florida, United States

Company Size

1001-5000 employees

Founded

1952

View Profile

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.