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FT- RN Case Management/ Utilization Review Coordinator

Company: Surgery Partners
Location: Durham
Posted on: January 26, 2023

Job Description:

DescriptionNorth Carolina Specialty Hospital (NCSH) is now seeking qualified candidates for
FT- RN Case Management/ Utilization Review Coordinator for Performance Review Department
North Carolina Specialty Hospital (NCSH) has a long-standing tradition of providing quality care for our patients. Our state-of-the-art medical facility located in the Raleigh-Durham area specializes in orthopedic, ophthalmology, ear, nose, and throat as well as sports medicine, oral, plastic, podiatry, general bariatric, interventional radiology, pain management, and reconstructive surgery. We tailor our facility and resources to best fit the needs of each. We are able to provide individualized attention to each and every patient we serve, with physicians providing personalized care.
NCSH offers competitive pay, full benefits package (including, but not limited to: health, dental, vision, life and disability insurance), 401K plans with company match and Paid Time Off.
Job Summary: Under the direction of the Performance Outcomes Director, this position is responsible for coordinating patients in the healthcare continuum to achieve optimal clinical, financial, operational and satisfaction outcomes. Act in a liaison function with the interdisciplinary healthcare team to promote and/or facilitate utilization of medical services. Identify and intervene when necessary to ensure efficient and cost-effective delivery of patient care services. Establish and promote collaborative relationships with physicians, patients, families, and additional members of the healthcare team. Educate members of the healthcare team on utilization review and managed care concepts. Act as a resource for routine and complex problem solving as it relates to utilization review and case management. Anticipate the needs of customers and work proactively to improve services. Work with others to improve customer satisfaction and participates in special projects as needed.
Skills & Abilities:

  • Able to work independently and met established deadlines
  • Able to make sound reasonable decisions
  • Highly organized
  • Ability to concentrate on many detailed requests
  • Demonstrates accountability, professionalism, openness, receptive to change, creativity and innovative
  • Ability to identify and calmly handle inherently stressful situation with tact
  • Excellent communication skills
  • Ability to develop excellent working relationships with consumers and staff
  • Seeks guidance, direction and assistance when needed
  • Ability to be flexible and take on new responsibilities

    Training & Education:

    • Graduate of an accredited school of professional nursing required
    • Current licensure in the State of North Carolina required
    • Current certification BLS
    • Must be able to communicate and understand the English language both verbal and written


      • A minimum of 1 year previous Medical and/or Surgical nursing experience preferred
      • Utilization Review and Case Management experience required

        COVID-19 protocol mandatory staff vaccinations, face masks, social distancing, terminal cleaning, patient testing, and visitor restrictions.

Keywords: Surgery Partners, Durham , FT- RN Case Management/ Utilization Review Coordinator, Executive , Durham, North Carolina

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