…throughput while supporting a balance of optimal care and appropriate resource utilization .​ ​ + ​Provides case management services for both inpatient and

…experience **FINANCE ESSENTIAL FUNCTIONS** + Uses resources efficiently to maximize utilization of time and equipment, providing guidance to team members

Under general supervision, the Utilization Review Coordinator provides professional assessment, planning, coordination, implementation and reporting of complex

The Utilization Review Medical Director supports operations and direction of the Care Coordination, Clinical Documentation, and Utilization Management

…clinical criteria and relevant Carelon Medical Benefits Management policies pertaining to utilization review . + Demonstrate and maintain knowledge of applicable

…is preferred . BSN is preferred . Certification in Case Management, Nursing or Utilization Review is preferred HCA Florida North Florida Hospital is a 523-bed,

…Demonstrate and maintain knowledge of relevant policies and regulations pertaining to utilization review of diagnostic imaging procedures, cardiac services and

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

…monitoring and evaluation of case management services through the appropriate utilization of resources. Application of appropriate medical necessity tools to

…TRICARE directives, coordinating with the local Medical Home Port (MHP) clinic, utilization and Referral Management policies, and obtains additional clinical data as