RN, Utilization Management Lead | Utilization Management| Day Full Time

UF Health; Gainesville (FL); On-site; USD 70,000 - 85,000; Full time

Job summary

UF Health in Gainesville, FL is looking for an RN Utilization Lead to ensure that the right care is provided at the right time through excellent utilization management. This is a full-time onsite position scheduled from Thursday to Sunday, 5:30 AM to 4:00 PM.

The ideal candidate will have a current RN license in Florida and at least two years of experience in utilization review. Knowledge of diagnostic related groups (DRGs) and strong communication skills are also essential.

Qualifications

• Minimum of two (2) years experience performing utilization review in a hospital setting.
• Knowledge of diagnostic related groups (DRGs) and coding preferred.

Responsibilities

• Perform all duties in accordance with the utilization review plan.
• Provide operational logistics in the absence of the Director.

Skills

Utilization review

Strong communication skills

Computer proficiency

Education

Registered Nurse (RN) with a current Florida license

Job description

Overview

Make an impact by supporting the right care at the right time through utilization management excellence.

Job Details

• Title: RN Utilization Lead
• Work Style: Onsite
• Location: Gainesville, FL
• FTE: Full-time (1.00 FTE)
• Schedule: Thursday-Sunday - 5:30 AM - 4:00 PM

Responsibilities

• Perform all duties in accordance with the utilization review plan, Federal and State guidelines, and TJC standards.
• Provide operational logistics in the absence of the Director.

Qualifications

• Registered Nurse (RN) with a current Florida license.
• Minimum of two (2) years experience performing utilization review in a hospital setting, for a third party payer or other review agency or organization.
• Knowledge of diagnostic related groups (DRGs), Federal and State guidelines, commercial and other payer groups and coding preferred.
• Strong written and verbal communication skills.
• Ability to type and use a computer proficiently.

Licensure/Certification/Registration: Registered Nurse.