RN Utilization Review & Care Coordination

UF Health; Town of Florida (NY); On-site; USD 70,000 - 90,000; Full time

Job summary

A healthcare organization is seeking an experienced Registered Nurse (RN) in Florida. The role involves evaluating patient medical records for necessary healthcare services and ensuring compliance with management guidelines. Candidates should have strong experience in utilization review or case management and excellent communication skills. This position requires the ability to analyze data and coordinate care effectively within a multidisciplinary team.

Qualifications

• Active RN license with strong experience in utilization management required.
• Proven track record in case management or critical care nursing.
• Must possess excellent communication skills for authorization decisions.

Responsibilities

• Evaluate patient medical records for healthcare service necessity.
• Coordinate with providers for compliance with management guidelines.
• Analyze utilization data to enhance care coordination.

Skills

Utilization review

Case management

Critical thinking

Communication

Analytical skills

Attention to detail

Organizational skills

Education

Active Registered Nurse (RN) license

3+ years of experience in utilization review or case management

3 years of critical care nursing experience or 5 years of medical-surgical nursing

Job description

A healthcare organization is seeking an experienced Registered Nurse (RN) in Florida. The role involves evaluating patient medical records for necessary healthcare services and ensuring compliance with management guidelines. Candidates should have strong experience in utilization review or case management and excellent communication skills. This position requires the ability to analyze data and coordinate care effectively within a multidisciplinary team.