Utilization Review Nurse | Corporate Utilization Management | PRN | Variable

UF Health • Leesburg, FL

15d

About The Position

The Utilization Review Nurse is responsible for evaluating the appropriateness of hospital admissions, resource utilization, and medical necessity for continued stays. This role facilitates timely discharges, ensures medical documentation accurately reflects patient severity of illness, and provides appropriate interventions and discharge planning services in collaboration with Case Management. Performs other related duties as assigned.

Requirements

• Ability to read, write, speak, and understand English
• Minimum of five (5) years of clinical experience
• Current Florida nursing license required
• Strong observation, analytical, and problem-solving skills
• Excellent written and verbal communication skills
• Ability to effectively communicate with physicians, patients/clients, families, and interdisciplinary staff
• Associate’s Degree required

Nice To Haves

• Professional Certification in Case Management (CM) preferred
• Case Management (CM) certification preferred
• Current working knowledge of utilization management, performance improvement, and reimbursement issues preferred
• Experience in utilization review, case management, appeals, denials, and managed care contracting preferred

What This Job Offers

• Job Type: Part-time
• Education Level: Associate degree
• Number of Employees: 5,001-10,000 employees