Utilization Management RN Remote
New York, USA
Listed on 2026-01-06
-
Nursing
RN Nurse, Clinical Nurse Specialist
Our promise to you:
Joining Advent Health is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. Advent Health is a place where you can thrive 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.
All while understanding that together we are even better.
- Benefits from Day One:
Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance - Paid Time Off from Day One
- 403-B Retirement Plan
- 4 Weeks 100% Paid Parental Leave
- Career Development
- Whole Person Well-being Resources
- Mental Health Resources and Support
- Pet Benefits
Full time
Shift:Day (United States of America)
Address:900 WINDERLEY PL
City:MAITLAND
State:Florida
Postal Code:32751
Job Description:- Shift: Monday-Friday 8am-4:30pm, every 4th weekend, may vary based on business needs.
- Schedule:
Full Time Remote, Applicant must live within a 50-mile radius or be a current employee within an Adven Health region. - Monitor admissions and perform initial and continued stay medical necessity reviews.
- Maintain thorough knowledge of payer guidelines and regulatory requirements and manages concurrent and pre-bill denials to prevent loss of reimbursement.
- Collaborate and communicate with the multidisciplinary care team regarding patient status and concurrent 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.
QUALIFICATION REQUIREMENTS: Associate's of Nursing (Required), Bachelor's of Nursing, Accredited Case Manager (ACM) - EV Accredited Issuing Body, Certified Case Manager (CCM) - EV Accredited Issuing Body, Registered Nurse (RN) - EV Accredited Issuing Body
Pay Range:$68,132.50 - $
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.
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