Utilization Management Registered Nurse - Correct Care Solutions - Pompano Beach, FL | JobsInFL.com

Utilization Management Registered Nurse

Correct Care Solutions | Pompano Beach, FL 33060

Correct Care Solutions


Our UM Nurse will assist with analyses of medical necessity, level of care, care progression, and resource utilization.

Qualifications

Education:           
  • Graduation from an accredited School of Nursing

Experience:        
  • Previous experience working with utilization management
  • Computer data entry experience

Licenses/Certifications: 
  • Current licensure as a Registered Nurse


Responsibilities

  • Utilizes nationally recognized evidence-based criteria to determine medical necessity of requested services, diagnostics, specialty care, or inpatient care.
  • Refers provider requests when the requested services do not meet the recognized criteria.
  • Coordinate with healthcare staff and providers to plan for discharge back to DOC institutions.
  • Reviews information to determine the level of care or the medical necessity of any services requested by a provider.
  • Reviews and audit inmate medical records to determine what services or procedures are medically necessary.
  • The above responsibilities are a highlight of responsibilities and not a full list. Other responsibilities may be performed as assigned.


  • CCS is an EOE/Minorities/Females/Vet/Disability Employer

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    Application Instructions

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    Job Code: 18-55896
    Posted On: 09/28/182018-09-28
    Closing Date: Open Until Filled
    Telecommute: No
    Categories: Healthcare, Nursing, Management
    Job Type: Regular
    Job Status: Full Time
    Similar Jobs: Within 25 miles of 33060, Healthcare, Nursing, Management


    Additional Contact Info

    Phone: 207-512-8549

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