…a specified patient care area, and for the acquisition, development, and utilization of resources (human and material) needed to fulfill those responsibilities. We

…RAC for reversal of original determination. May serve on the Medical Record/ Utilization Review Committee, providing detailed logs of denial activity and appeal

…care and cost effectiveness through the integrating and functions of case management, utilization review and discharge planning. The Care Manager must be highly

…census/ utilization in all programs they oversee. Oversees the internal utilization review process for their assigned programs. Assists the Vice-President

…(ie Med-Surg, Tele, ICU, PCU etc) + Certification in case management or utilization review preferred + InterQual experience preferred HCA Florida Northwest

…hospitalization reports, family, and team meetings. + Develops and participates in the Utilization Review of medical services. + Develops and supervises the

…2 years of case management experience + Certification in case management or utilization review preferred + InterQual experience preferred HCA Florida Northwest

…2 years of case management experience + Certification in case management or utilization review preferred + InterQual experience preferred **Schedule** + Per Diem

…guidelines. Participates in developing department goals and clinical programming. + Performs utilization review as assigned. + Helps with Process and Quality

…reports. Participates in departmental and interdepartmental staff meetings, in-services, utilization review programs, committees, student preceptor and/or mentor