Utilization Management Case Manager

Company: Lee Health
Location: Fort Myers
Posted on: June 8, 2021

Job Description:

This position will be remote after the successful completion of the 90 day probationary period. Performs utilization management functions that assure regulatory compliance, medical necessity and appropriate level of care specifically for PACU system-wide, as well as EQ Health submissions. Facilitates concurrent documentation in the medical record to accurately reflect care, services and resources utilized in the delivery of patient care. Successfully meets requirements for productivity and accuracy related to all utilization management processes.

Educational Requirements

Degree/Diploma ObtainedProgram of StudyRequired/

Preferredand/orBachelor'sNursingPreferredorBachelor'sSciencePreferred

Additional Requirements

Graduate of an accredited school of nursing. BSN or BS in a related healthcare field, or able to obtain within the first year of hire.

Experience Requirements

Minimum Years RequiredArea of ExperienceRequired/

Preferredand/or3 YearsAcute CarePreferred

Additional Requirements

Or equivalent utilization management experience within 2 years with a focus on acute care preferred.

State of Florida Licensure Requirements

LicensesRequired/

Preferredand/orRegistered Nurse LicenseRequired

Certifications/Registration Requirements

Certificates/RegistrationsRequired/

Preferredand/orACM (Accredited Case Manager)RequiredorCCM (Certified Case Manager)RequiredorNACCM (National Academy of Certified Care Managers)Required

Additional Requirements

Require Case Management certification, ACM, CCM, CMCN or NACCM after 3 yrs. employment (time exception provided for unsuccessful attempts).

Keywords: Lee Health, Fort Myers , Utilization Management Case Manager, Other , Fort Myers, Florida