All the benefits and perks you need for you and your family:

Paid Days Off from Day One

Student Loan Repayment Program

Career Development

Whole Person Wellbeing Resources

Mental Health Resources and Support

Our promise to you:

Joining AdventHealth is about being part of something bigger. Its about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

Schedule: Full Time

Shift :Days

Location: Virtual

The community youll be caring for: AdventHealth Division

AdventHealth Tampa, a faith-based not-for-profit 626-bed tertiary-level acute care hospital located in the uptown district of Tampa, Florida, specializes in advanced cardiovascular medicine, neuroscience and neurology, digestive health, orthopedics, womens services, pediatrics, oncology, endocrinology, bariatrics, wound healing, sleep medicine and general surgery including minimally invasive and robot-assisted procedures. GME programs on the hospital campus currently include general surgery, obstetrics and gynecology, internal medicine and transitional year.

AdventHealth Tampa is home to the renowned AdventHealth Pepin Heart Institute, a recognized leader in cardiovascular disease prevention, diagnosis, treatment and leading-edge research caring for Tampa Bays hearts for over 35 years.

The Kiran C. Patel Research Institute, also located at AdventHealth Tampa, leads the way in clinical and academic research in the areas of neuroscience, cardiovascular medicine, advanced surgery and more contributing valuable knowledge that leads to tomorrows cures for conditions such as heart failure, cancer and other diseases.

The role youll contribute:

The Utilization Management (UM) Specialist works under the direction of the Utilization Management Manager and supports the Utilization Management team with Emergency, Observation and Inpatient visits. The UM Specialist is responsible for providing clerical assistance to the Utilization Management Nurses (UM RN) to assist with verification of benefits, authorization procurement and other assigned tasks as needed. The UM Specialist is responsible for collaborating with the UM RN and other members of the interdisciplinary team (i.e. Physicians, Care Managers, Social Workers, etc.) or interdependent departments (i.e. Patient Access, Billing, etc.) to ensure unnecessary delays in patient care, discharge or billing. The UM Specialist will serve as the first point of escalation for payors requiring assistance in gaining additional or missing information to support authorization. The UM Specialist will be responsible for ensuring procurement of authorization upon admission and discharge as well as, accuracy of authorization information. The UM Specialist will ensure timely escalation of barriers to authorization requiring clinical expertise and assist in coordination of Peer to Peer discussions with the payor.

The value youll bring to the team:

Coordinates and supports clerical and administrative activities of the Utilization Management team.

Collaborates and communicates with payor via phone, fax or payor portal.

Tracks and monitors requests through EMR.

Ensures incoming requests are responded to promptly and accurately.

Obtains and enters authorization numbers from payors.

Qualifications

Category: Case Management

Organization: AdventHealth Tampa

Schedule: Full-time

Shift: 1 - Day

Req ID: 25025630

We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.