At BayCare, we are proud to be one of the largest employers in the Tampa Bay area. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. With the support of more than 30,000 team members, we promote a forward-thinking philosophy that’s built on a foundation of trust, dignity, respect, responsibility and clinical excellence.

 

BayCare Health System is currently seeking a Utilization Review Specialist Senior to join our outstanding and compassionate team.

The Utilization Review Specialist Senior responsibilities include:

Functions as the primary liaison between the funding agents and all other related parties to ensure appropriate level of care through comprehensive concurrent review for medical necessity of outpatient observation and inpatient stays and the utilization of ancillary servicesPerform other duties as assigned by the supervisor including but not limited to processing concurrent denials.Preferred experience includes Critical Care or Emergency Nursing RN.

 

Certifications and Licensures:

Required RN (Registered Nurse)Preferred ACM (Case Management)Preferred CCM (Case Manager)

 

Education:

Required Associates in Nursing orRequired Bachelors in NursingPreferred Masters in Nursing or Business

 

Experience:

Required 2 years in Utilization Review orRequired 2 years in Case ManagementPreferred 3 years Registered Nurse in Critical Care or Emergency Service

 
Facility: BayCare Health System, Utilization and Denials Mgmt-MPH

Location: Morton Plant

Status: Part Time, Exempt: No

Shift Hours: 8:00 AM - 4:30 PM

Weekend Work: Every

On Call: No

How often will this team member be working remotely? Never

Benefits:

Benefits (Health, Dental, Vision)Paid time offTuition reimbursement401k match and additional yearly contributionYearly performance appraisals and team award bonusCommunity discounts and more

Equal Opportunity Employer Veterans/Disabled