RN Utilization Management Specialist - Onsite Care

UF Health; Leesburg (FL); On-site; USD 85,000 - 110,000; Full time

Job summary

UF Health Leesburg is seeking an experienced RN for an onsite Utilization Review/Case Management role. You will evaluate medical records, collaborate with interdisciplinary teams, and support discharge planning to ensure timely, appropriate care.

The position emphasizes regulatory compliance, documentation accuracy, and clear communication of authorization decisions, with a Monday–Friday schedule and occasional weekends at UF Health Leesburg.

Qualifications

• Active Florida RN license required.
• 3+ years critical care, or 5 years medical-surgical, or 3 years utilization review/case management.
• Strong knowledge of utilization management guidelines and regulatory compliance.
• Excellent communication and collaboration with multidisciplinary teams.

Responsibilities

• Evaluates patient records to determine necessity and appropriateness of services.
• Coordinates with providers to ensure compliance with utilization guidelines.
• Supports treatment plan optimization for effective patient care.
• Communicates authorization decisions clearly and supports discharge planning.
• Analyzes utilization data to identify trends and improvement opportunities.
• Maintains accurate documentation and adheres to regulatory standards.

Skills

Utilization review

Care coordination

Regulatory compliance

Documentation

Communication skills

Team collaboration

Education

RN license (FL)

Job description

UF Health Leesburg is seeking an experienced RN for an onsite Utilization Review/Case Management role. You will evaluate medical records, collaborate with interdisciplinary teams, and support discharge planning to ensure timely, appropriate care.

The position emphasizes regulatory compliance, documentation accuracy, and clear communication of authorization decisions, with a Monday–Friday schedule and occasional weekends at UF Health Leesburg.