COORD - CASE MGMT/UTILIZ REV FULL TIME DAYS

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.

Case Manager/Utilization Review Coordinator Full Time

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.

To learn more visit Welcome - Alan B. Miller Medical Center | Palm Beach Gardens, FL

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.

Qualifications

Case Manager/Utilization Review Coordinator 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

Role and Responsibilities

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.

About Universal Health Services

One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (NYSE: UHS) has built an impressive record of achievement and performance, growing since its inception into a Fortune 500 corporation. Headquartered in King of Prussia, PA, UHS has 99,000 employees. Through its subsidiaries, UHS operates 28 acute care hospitals, 331 behavioral health facilities, 60 outpatient and other facilities in 39 U.S. States, Washington, D.C., Puerto Rico and the United Kingdom.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.

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