Registered Nurse - Utilization Manager

Giacare Inc • Tampa, FL

6d • Onsite

About The Position

Join the 6 MDG healthcare team as a Utilization Manager RN, applying clinical review criteria to support appropriate, efficient use of care for active-duty service members, retirees, and their families.

Requirements

• U.S. Citizen, U.S. national, lawful permanent resident, or individual otherwise authorized to work in the United States
• Associate's Degree of Nursing (TE5 floor)
• Current, full, active, unrestricted Registered Nurse license in any U.S. state, territory, or the District of Columbia
• Prior clinical nursing experience; utilization review/utilization management experience strongly preferred
• Current Basic Life Support (BLS) certification (or willing to obtain)
• Able to pass a Tier 1 (or higher) background investigation for facility and network access
• 3 years in last 4 years as a registered nurse in utilization management

Nice To Haves

• Experience applying InterQual, MCG, or comparable utilization review criteria
• Experience in utilization management within a military treatment facility or managed-care setting
• Strong analytical, documentation, and cross-team communication skills

Responsibilities

• Conduct utilization review and medical necessity determinations using established clinical criteria
• Review admissions, continued stay, and level-of-care decisions in coordination with providers
• Support the facility's utilization management program and related reporting requirements
• Collaborate with case management, providers, and MTF leadership on utilization trends
• Accurately and timely report data through required government reporting systems
• Document review activity within the electronic medical record

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree