Alan B. Miller Medical Center · 5 hours ago
COORD - CASE MGMT/UTILIZ REV FULL TIME DAYS
Palm Beach Gardens, FL
Full-time
Onsite
Mid, Senior Level
3+ years expAlan B. Miller Medical Center is a new state-of-the-art hospital set to open in Spring 2026, part of the UHS regional network of healthcare operations. The Case Manager/Utilization Review Coordinator will assess patient medical records for care necessity and appropriateness, liaising between providers, patients, and payers to secure authorizations and manage denials while promoting efficient resource use.
Health CareHealth DiagnosticsHospital
Responsibilities
A Utilization Review (UR) Nurse assesses patient medical records to ensure care is medically necessary, appropriate, and cost-effective, working as a liaison between providers, patients, and payers to secure authorizations, manage denials, and promote efficient resource use, balancing clinical quality with fiscal responsibility through documentation, communication, and adherence to guidelines like InterQual or MCG criteria
They work to balance high-quality care with cost control by reviewing documentation, communicating with healthcare teams, and facilitating proper insurance authorization for services like hospital stays, procedures, or discharges
Qualification
Required
Graduate of an accredited school of nursing required
Acute Care Hospital experience
Strong organization and file management
Proficiency in office software (MS Office, email, databases)
Excellent written and verbal communication
Ability to multitask and handle sensitive information
Acute care clinical experience (typically 3-5 years)
Knowledge of InterQual or MCG
Strong analytical, communication, and documentation skills
Familiarity with CMS, Medicare, Medicaid, and commercial payer rules
Active and current Florida RN license
Preferred
BSN preferred
Benefits
Challenging and rewarding work environment.
Competitive Compensation & Generous Paid Time Off.
Excellent Medical, Dental, Vision and Prescription Drug Plans.
401(K) with company match and discounted stock plan.
SoFi Student Loan Refinancing Program.
Career development opportunities within UHS and its 300+ Subsidiaries!
Company
Alan B. Miller Medical Center
Alan B. Miller Medical Center is a healthcare center that provides orthopedic, neuro, heart, advanced imaging, and critical care services.
1001-5000 employees
Funding
Current Stage
Late StageCompany data provided by crunchbase