Utilization Management Specialist | Utilization Management

UF Health Psychiatric Hospital - Gainesville

Job ID: 88583
Full/Part Time: Full-Time
Regular/Temporary: Regular
Department: Utilization Management
Shift/Days: 8 a.m. - 6 p.m., Monday-Friday
Posted FTE: 1.00 = 40 Hours

Job Opening Summary

Responsible for management, coordination and documentation of utilization and external review activities to ensure an active and effective utilization management program. All duties are performed in accordance with the utilization review plan; federal and state rules, regulations and guidelines; and JCAHO standards. In collaboration with members of the Shands at Vista clinical teams, is responsible for the coordination of resource utilization management and for patient/family education regarding resource allocation decision-making.
 

Job Opening Qualifications

Minimum Education and Experience Requirements:

  • Master's degree in social work (MSW) or other related clinical field from accredited university required.
  • Must possess strong written and verbal communication skills.
  • Is able to negotiate and manage challenging situations diplomatically.
  • Ability to weigh the patient's medical and psychosocial-emotional needs against criteria to assist the clinical team in determining most appropriate use of resources.
  • Ability to use a computer required.
  • Postgraduate experience in behavioral health preferred.
  • Experience performing utilization review in a hospital setting for a third-party payor or other review agency or organization preferred.
  • Knowledge of federal and state guidelines, peer review organizations and other payor groups preferred.


Licensure/Certification/Registration:

  • Florida licensure in social work or related clinical field, or license-eligible and actively working to obtain licensure preferred.


Minimum Pay Rate - Hourly: $28.46
Midpoint Pay Rate - Hourly: $39.50

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Internal Applicants - Apply Here

We invite you to join our team! Our work and passion for excellence are intended to have an impact beyond the communities in which we serve. You may apply for a maximum of 10 positions at any given time. For general application process topics please review our Frequently Asked Questions. For technical assistance please contact Human Resources at 352-265-0441.


UF Health Shands Hospital is committed to diversity as a competitive advantage in attracting top talent from across the nation and around the world. We believe in sharing knowledge, learning from one another, valuing different opinions, and celebrating the things that make each one of us unique in our own right. UF Health Shands Hospital is an equal opportunity employer and drug-free workplace. Equal Opportunity Employer M/F/D/V


UF Health Psychiatric Hospital - Gainesville
Gainesville, FL 32608



Why Work With UF Health

Benefits
Benefits to fit your life.

As you would expect from an organization this size, our core benefits include medical insurance and prescription drug plans, short-term and long-term disability, life insurance, generous paid time off, 10 paid holidays per year and an employee assistance plan. Voluntary benefits include tuition reimbursement, dependent care and health care reimbursement accounts, dental insurance, vision plan and more. Retirement benefits include a 403(b) plan.

About UF Health
About UF Health

UF Health Shands is recognized as Florida’s premier hospital system, thanks to our commitment to quality clinical care that yields outstanding outcomes and continually earns us national recognition. It is our privilege to offer distinguished, patient-centered care and build upon our role as the state’s premier provider of medical expertise and specialties.

UF Health ranks 53rd on the 2021 Forbes list of Florida’s 100 best workplaces and ranks 31st on their list of best workplaces in the nation for women. UF Health Shands Hospital was included in Indeed’s list of the “2019 Top-Rated Workplaces” for hospitals, which recognizes the 25 “Best Hospitals” in the U.S. We are number 20.

About The Area
Welcome to the Sunshine State.

There’s a reason the Sunshine State is the tourism capital of the world and the third-most populous state in the country. As a Florida resident, you’re never far from the world’s best beaches, theme parks and attractions (and their Florida resident discounts), and cultural arts. Factor in our favorable tax rate and entrepreneurial spirit, and it’s easy to see why so many individuals, families and businesses choose to make Florida their home.

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