A company is looking for a Concurrent Denial Nurse BU - Utilization Management.
Key Responsibilities
Review and analyze concurrent and retrospective clinical inpatient denials to ensure medical necessity criteria is met
Serve as a resource for Utilization Management functions and support communication between payers and the hospital
Collaborate with the local physician advisor team and assist with education and monitoring of UM specialist's reviews
Required Qualifications
Completion of an accredited Registered Nursing Program (RN)
Bachelor's Degree in Nursing or related field
Current valid license in the State of Florida as a Registered Nurse (RN)
Basic Life Support (BLS) certification through the American Heart Association (AHA) or American Red Cross
Three years of full-time Utilization Management experience
Licensed Nurse Florida • West Palm Beach, Florida, United States