COORD - CASE MGMT/UTILIZ REV FULL TIME DAYS

Case Manager/Utilization Review Coordinator

Responsibilities Alan B. Miller Medical Center opening in Spring 2026! A neighborhood hospital with medical center excellence! The new state-of-the-art hospital will join UHS' growing regional network of healthcare operations which includes Wellington Regional Medical Center, the ER at Westlake (an extension of Wellington Regional Medical Center), Wellington Physicians Urgent Care and other healthcare services and access points. The Alan B. Miller Medical Center will feature 150 private patient rooms, a medical office building and a helistop. Upon completion of the initial phase of the project, the hospital campus will include 365,000 square feet of hospital and medical office space. The new Medical Center will offer comprehensive medical services including Emergency Care, Orthopedics and Surgical Services, Oncology, Cardiovascular and Neurosurgical services. In addition, the campus will be home to medical office buildings that will provide outpatient services.

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.

Benefit Highlights 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! More information is available on our Benefits Guest Website: benefits.uhsguest.com.

Job Requirements

Education Requirements: Graduate of an accredited school of nursing required. BSN preferred.

Experience: Acute Care Hospital experience

Skills: 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

License / Certification: Active and current Florida RN license. Travel Requirements: none