RN Utilization Management & Care Coordination

UF Health Central Florida; Leesburg (FL); On-site; USD 70,000 - 90,000; Full time

Job summary

UF Health Leesburg is seeking an on-site Utilization Review Nurse to evaluate patient records and determine medical necessity for services in alignment with UM guidelines. You will collaborate with clinicians to support compliant, efficient care and timely discharge planning.

The role requires an active Florida RN license with 3+ years in utilization review or case management, strong communication, and the ability to analyze utilization data to improve care coordination.

Qualifications

• Registered Nurse license required and current in Florida.
• 3+ years of utilization review, case management, or comparable experience.
• Knowledge of utilization management guidelines and regulatory requirements.

Responsibilities

• Evaluate medical records to determine medical necessity and appropriateness of services.
• Collaborate with providers to ensure compliance with guidelines and optimize care plans.
• Communicate authorization decisions clearly and support discharge planning.

Skills

Communication skills

Analytical skills

Team collaboration

Attention to detail

Education

Active RN license

Job description

UF Health Leesburg is seeking an on-site Utilization Review Nurse to evaluate patient records and determine medical necessity for services in alignment with UM guidelines. You will collaborate with clinicians to support compliant, efficient care and timely discharge planning.

The role requires an active Florida RN license with 3+ years in utilization review or case management, strong communication, and the ability to analyze utilization data to improve care coordination.