Utilization Review, Case Management

Full Time
Posted 11 months ago

Job Description: Nurse case manager M-F 8-5 or 9-6


  • Growing innovative healthcare company
  • Family owned & operated for more than 34 years
  • Awesome benefits & bonuses
  • Flexible environment


  • Day to day care management of patients.
  • Follow up with providers.
  • Screen current & future admissions.
  • Screen for early discharge potential.
  • Communicate regarding short & long term goals for patients.
  • Coordinate the utilization of network resources to patients.
  • Identify cost effective alternatives to continuity of care.
  • Able to work with Pharmacy Benefits Manager.
  • Facilitate patient reporting to clients.


  • Organized & high attention to detail.
  • Empathize with patients both in person & over the phone
  • Mindful of business & regulatory requirements.

Required experience:

  • Valid RN or LPN license
  • Case management experience preferred.
  • Knowledge of self-funded employer sponsored health plans/stop-loss a plus

Job Features

Job CategoryBSN, LPN, RN

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