COORD - CASE MGMT/UTILIZ REV FULL TIME DAYS
UHS
Riviera Beach, FL (In Person)
Full-Time
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Job Description
Benefits Guest Website:
benefits.uhsguest.com.Qualifications Case Manager/Utilization Review Coordinator Job Requirements:
Education Requirements:
Graduate of an accredited school of nursing required. BSN preferred.Experience:
Acute Care Hospital experienceSkills:
Strong organization and file management. Proficiency in office software (MS Office, email, databases). Excellent written and verbal communication. Ability to multitask and handle sensitive information. Acute care clinical experience (typically 3-5 years) Knowledge of InterQual or MCG Strong analytical, communication, and documentation skills Familiarity with CMS, Medicare, Medicaid, and commercial payer rules License /Certification :
Active and current Florida RN license.Travel Requirements :
none Role and Responsibilities A Utilization Review (UR) Nurse assesses patient medical records to ensure care is medically necessary, appropriate, and cost-effective, working as a liaison between providers, patients, and payers to secure authorizations, manage denials, and promote efficient resource use, balancing clinical quality with fiscal responsibility through documentation, communication, and adherence to guidelines like InterQual or MCG criteria. They work to balance high-quality care with cost control by reviewing documentation, communicating with healthcare teams, and facilitating proper insurance authorization for services like hospital stays, procedures, or discharges. About Universal Health Services One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (NYSE:
UHS) has built an impressive record of achievement and performance, growing since its inception into a Fortune 500 corporation. Headquartered in King of Prussia, PA, UHS has 99,000 employees. Through its subsidiaries, UHS operates 28 acute care hospitals, 331 behavioral health facilities, 60 outpatient and other facilities in 39 U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. EEO Statement All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success. Avoid and Report Recruitment Scams At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.Qualifications:
Case Manager/Utilization Review Coordinator Job Requirements:
Education Requirements:
Graduate of an accredited school of nursing required. BSN preferred.Experience:
Acute Care Hospital experienceSkills:
Strong organization and file management. Proficiency in office software (MS Office, email, databases). Excellent written and verbal communication. Ability to multitask and handle sensitive information. Acute care clinical experience (typically 3-5 years) Knowledge of InterQual or MCG Strong analytical, communication, and documentation skills Familiarity with CMS, Medicare, Medicaid, and commercial payer rules License /Certification :
Active and current Florida RN license.Travel Requirements :
none Role and Responsibilities A Utilization Review (UR) Nurse assesses patient medical records to ensure care is medically necessary, appropriate, and cost-effective, working as a liaison between providers, patients, and payers to secure authorizations, manage denials, and promote efficient resource use, balancing clinical quality with fiscal responsibility through documentation, communication, and adherence to guidelines like InterQual or MCG criteria. They work to balance high-quality care with cost control by reviewing documentation, communicating with healthcare teams, and facilitating proper insurance authorization for services like hospital stays, procedures, or discharges. About Universal Health Services One of the nation s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (NYSE:
UHS) has built an impressive record of achievement and performance, growing since its inception into a Fortune 500 corporation. Headquartered in King of Prussia, PA, UHS has 99,000 employees. Through its subsidiaries, UHS operates 28 acute care hospitals, 331 behavioral health facilities, 60 outpatient and other facilities in 39 U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. EEO Statement All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success. Avoid and Report Recruitment Scams At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.Similar jobs in Riviera Beach, FL
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