1mo ago

Utilization Management Specialist NE

Indian River Hospitalmid

OperationsManagement

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Quick Summary

Requirements Summary

Graduate from an accredited school of professional nursing (Diploma,

Technical Tools

OperationsManagement

Utilization Management Specialist NE

Vero Beach

Indian River Hospital

Utilization Review-Indian River Hospital

0009IR

Days

7:30am-4:30pm

CCIR Bidding Period: 9/14/26 - 9/18/26

Join our team at Cleveland Clinic Indian River Hospital and experience world-class healthcare at its best. Cleveland Clinic Indian River has been recognized as one of the top regional hospitals in South Florida. Indian River Hospital is in sunny Florida’s Treasure Coast where it is committed to providing optimal family-centric and community-focused care. At Indian River Hospital, you will be part of a collaborative, compassionate, and innovative team of caregivers. You will work with state-of-the-art technology and will build a rewarding career with one of the most respected healthcare organizations in the world.

Utilization Management (UM) Specialists perform UM activities, such as admission review, concurrent review, retrospective chart review and clinical systems review to measure clinical performance and UM issues that affect reimbursement for the patient’s hospital stay or visit. Your work impacts the denial rate, which in return would impact patients out of pocket expenses. Here, you will have the opportunity to work with a dynamic team of like-minded individuals and have the chance to grow your skills into a supervisor role.

Requirements

~1 min read

Requires walking, sitting, and/or standing for long periods of time.
Requires constant attention to detail, reading of medical records, and meeting deadlines.
Works in an environment where there is some discomfort due to dust, noise, temperature.

Follows standard precautions using personal protective equipment.

The policy of Cleveland Clinic Health System and its system hospitals (Cleveland Clinic Health System) is to provide equal opportunity to all of our caregivers and applicants for employment in our drug free environment. All offers of employment are followed by testing for controlled substances.

Cleveland Clinic Health System administers an influenza prevention program. You will be required to comply with this program, which will include obtaining an influenza vaccination on an annual basis or obtaining an approved exemption.

Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic Health System facility.

If applying for a Florida position, please see the following website for more information on the background screening requirements required by the Agency of Health Care Administration: https://info.flclearinghouse.com/

Please review the Equal Employment Opportunity poster.

Cleveland Clinic is pleased to be an equal employment opportunity employer.