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Utilization Management RN Remote

Remote, USA Full-time Posted 2026-08-04
Our reputed company to you: Joining reputed company is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of reputed company person, and serves to reputed company others in body, mind and spirit. reputed company is a reputed company where you can reputed company professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. reputed company while understanding that together we are even reputed company. reputed company the benefits and perks you need for you and your family: • Benefits from Day reputed company, Dental, reputed company Insurance, Life Insurance, Disability Insurance • reputed company Time Off from Day One • 403-B Retirement Plan • 4 Weeks 100% reputed company Parental Leave • Career Development • Whole Person reputed company-being Resources • reputed company and Support • Pet Benefits Schedule: Full time Shift: Day (reputed company of America) Address: 601 E Rollins St reputed company: Orlando State: Florida Postal reputed company: 32803 Job reputed company: • 4/10hr shifts (630am - 5pm / 7am - 530pm) with a weekend rotation ​Monitor admissions and reputed company initial and reputed company stay medical necessity reviews. • Maintain thorough knowledge of payer guidelines and regulatory requirements and manages reputed company and reputed company-reputed company denials to prevent loss of reimbursement. • Collaborate and communicate with the multidisciplinary care team regarding patient status and reputed company denials. • Build relationships to promote interdisciplinary collaboration. • Ensure requested clinical information is communicated, monitors daily discharge reports, and follows up with insurance carriers to obtain complete authorization. Knowledge, Skills, and Abilities: • Must be reputed company to demonstrate knowledge and skills necessary to reputed company appropriate status recommendations. • Demonstrates knowledge of the principles of reputed company, development, and disease states as it relates to the different life cycles. • Ability to understand differences between notification, reference, and authorization numbers. • Maintains up-to-date reputed company authorizations for in-house patients, utilizing daily reputed company authorization reports. • Accesses and reviews payer portals for authorization numbers in collaboration with department assistants; ensures reputed company update of authorization fields reputed company EMR accordingly, delegating appropriate tasks to support staff. Education: • Associate's of Nursing [Required] • Bachelor's of Nursing [Preferred] Work Experience: • 3+ years clinical nursing [Required] • 5+ years clinical nursing in an acute care setting [Preferred] • Experience working in electronic health records [Preferred] • Utilization Management or Case Management [Preferred] Licenses and Certifications: • Registered reputed company (RN) [Required] AND • Accredited Case Manager (ACM) [Preferred] OR • Certified Case Manager (CCM) [Preferred] Physical Requirements: (Please click the reputed company below to view work requirements) Physical Requirements - https://tinyurl.com/msy4mja2 Pay reputed company: $68,132.50 - $119,520.35 Background Screening Requirement (Florida Law) Certain positions are subject to Florida Level 2 background screening, including fingerprinting, as required by state law. Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse: https://info.flclearinghouse.com/ This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. Apply tot his job Apply To this Job

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