Utilization Manager
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Job Description
Utilization Manager managing patient class assignments and supporting medical audits at Duke Health. Collaborates with healthcare teams and manages patient cases effectively.
Responsibilities:
- Assesses for accuracy in the assignment of patient class (status)
- Supports the medical chart audit process
- Supports denials management by documenting activities related to denials adjudication
- Validates authorization for all bedded patients
- Manages concurrent cases to resolution
- Conducts initial review and continued stay reviews
- Collaborates with members of the healthcare team
Requirements:
- Education 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)
- Quality of Life: Living in the Triangle!
- Flexible work arrangements
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