Utilization Manager
Duke Careers
full-time
Posted on:
Location Type: Office
Location: Durham • North Carolina • 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
About the role
- Assesses for accuracy in the assignment of patient class (status)
- Supports the medical chart audit process
- Complies with current rules and regulatory requirements pertaining to utilization management.
- Initiates actions to obtain appropriate determinations
- Validates authorization for all bedded patients and commercial initiatives
- Manages concurrent cases to resolution care that may impact payer approval
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)
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
patient class assignmentmedical chart auditutilization managementauthorization validationcase management
Soft skills
accuracy assessmentproblem-solvingcommunicationcollaboration
Certifications
Case Management CertificationBLS certificationRN licensure