Florida Licensed Case Manager

Job Summary

To optimize patient care and resource utilization, the full-time Florida Licensed Case Manager will review medical records, ensure compliance with insurance guidelines, and collaborate with the healthcare team while working remotely.

Key responsibilities

• Review medical records to determine medical necessity for admissions and continued hospital stays
• Collaborate with multidisciplinary teams to facilitate discharge planning and reduce length of stay
• Manage financial clearance processes for potential transplant patients and ensure accurate billing and collections

Required qualifications

• Current Florida Licensed Case Manager certification
• Experience in case management and utilization management
• Knowledge of federal, state, and private insurance guidelines
• Ability to analyze financial information for patient eligibility
• Proficiency in electronic health record systems and patient registration processes