Highest Quality Nursing Built on Caring and Compassion
Baptist Health South Florida is the region’s largest not-for-profit healthcare organization with more than 23,000 employees working across 11 hospital campuses and more than 100 outpatient facilities throughout Miami-Dade, Monroe, Broward, and Palm Beach counties. In 2016 we welcomed the newest weapon in the fight against cancer, the world-class Miami Cancer Institute and proton therapy center.
Use your nursing experience to help patients in a whole new way. Join our innovative case management team at Baptist Health South Florida, as we strengthen our model that meets the needs of our patient community. We have an integrated collaborative Triad Model with specialists in Utilization Review, Social Work Case Management and RN Case Management to deliver comprehensive and patient centered care across the continuum.
UTILIZATION REVIEW RN OPPORTUNITIES Full-Time & Part-Time Opportunities available within our following locations:
You will conduct initial, concurrent, retrospective chart review for clinical financial resource utilization; and coordinate with healthcare team for optimal/efficient patient outcomes, while decreasing length of stay (LOS) and avoid delays and denied days. Accountable for a designated patient caseload and providing intervention, coordination to decrease avoidable delays, and denial of reimbursement; identifying delays in treatment or inappropriate utilization and serving as a resource; and ensuring/maintaining effective communication with Revenue Cycle Departments.
Associate’s degree in Nursing required.
Minimum 3 years hospital clinical experience required.
Current Florida RN license required.
Utilization Review or Case Management Certification required within 12 months of hire.
Excellent communication and negotiation skills.
Strong critical thinking skills and the ability to perform clinical/chart review abstract information efficiently.
Strong organizational and time management, analytical, data management and computer skills.
Current working knowledge of payer and managed care reimbursement preferred.
Ability to work independently and exercise sound judgment in interactions with the health care team and patients/families.
Knowledgeable in local, state, and federal legislation and regulations.
Ability to tolerate high volume production standards.
Baptist Health South Florida is once again one of the 2019 Fortune 100 Best Companies to Work For! This is the 19th time Baptist Health has been recognized on the list. We have also been recognized for being among the best healthcare providers in the nation by U.S. News & World Reports in its 2019-2020 Best Hospitals and have been honored as one of PEOPLE’s 2019 50 Companies that Care by PEOPLE magazine and Great Place to Work.
Baptist Health is an Equal opportunity Employer. These positions are not open to any third party recruiters, consultants and/or venders at this time.
Internal Number: See Above
About Baptist Health South Florida
Baptist Health South Florida is the largest faith-based, not-for-profit health care organization in the region. Its network of services supported by more than 16,000 employees extends throughout Miami-Dade, Broward, Palm Beach and Monroe Counties. Our facilities include Baptist Hospital, Baptist Children’s Hospital, Doctors Hospital, Fishermen’s Community Hospital, Homestead Hospital, Mariners Hospital, South Miami Hospital, West Kendall Baptist Hospital and the Miami Cancer Institute; outpatient diagnostic and surgical facilities, such as our Baptist Medical Plazas and home health care services in the region.
The Miami Cancer Institute and proton therapy center will usher in a new era of innovative, precision cancer treatment that is unmatched in South Florida today. Our not-for-profit facility is on track to bring nationally renowned oncology experts to what will become a world-class destination for patients from across the U.S., the Caribbean and Latin America.
Our International Center of Miami is one of the largest hospital-based international programs in America. Thousands of people each year travel to Miami from around the world to visit our respected physicians and our medical facilities.