Utilization Manager

Job not on LinkedIn

🕒 July 18

🌲 North Carolina – Remote

🌲 North Carolina – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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Duke Careers

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1924

💼 Consulting

🏥 Healthcare

📚 Education

Consulting • Healthcare • Education

Duke Careers is a platform connected to Duke University's rich legacy, established in 1924. It aims to celebrate the centennial of Duke University while providing resources, stories, and interviews that reflect the university's history, current achievements, and future aspirations. A key focus of Duke Careers is to engage with alumni and the community, showcasing the transformative impact of education and leadership within the university.

📋 Description

• Assesses for accuracy in the assignment of patient class (status). • Supports the medical chart audit process by ensuring accurate, timely, and informative clinical review documentation. • Supports denials management by documenting activities related to denials adjudication. • Collaborates with members of the healthcare team. • Validates authorization for all bedded patients. • Conducts initial review and continued stay reviews as designated. • Establishes and communicates estimated LOS and expected discharge date. • Facilitates mitigation of denials and peer-to-peer conversations. • Provides formal and informal education to physicians and healthcare team.

🎯 Requirements

• BSN required • Minimum of three years recent acute clinical practice or related health care experience. • Requires Case Management Certification (ACM, CCM or ANCC) within 2 years of hire. • Must have current or compact RN licensure in state of NC. • BLS certification required.

🏖️ Benefits

• Relocation Assistance (based on eligibility)