Senior Utilization Review Nurse - Hybrid PRN

Baycare; Tampa (FL); Hybrid; USD 70,000 - 100,000; Full time

Benefits offered by this job

401k match

Community discounts

Job summary

BayCare in Tampa, FL invites an experienced Utilization Review Senior RN for a PRN/hybrid role at St. Josephs. You will coordinate care with funding agents, perform concurrent reviews for medical necessity of outpatient observation and inpatient stays, and handle concurrent denials as needed.

Strong RN background with case management preferred; requires 2+ years in utilization review or case management. This position offers hybrid work at St.

Qualifications

• RN licensure with active state license
• ACM (Case Management) preferred
• CCM (Case Manager) preferred

Responsibilities

• Act as primary liaison between funding agents and care teams to ensure appropriate level of care
• Conduct comprehensive concurrent review for medical necessity of outpatient observation and inpatient stays
• Process concurrent denials as needed
• Perform other duties as assigned by supervisor

Skills

Utilization Review

Case Management

Critical Care

Emergency Nursing

Education

Associates in Nursing

Bachelor in Nursing

Masters in Nursing or Business

Job description

BayCare in Tampa, FL invites an experienced Utilization Review Senior RN for a PRN/hybrid role at St. Josephs. You will coordinate care with funding agents, perform concurrent reviews for medical necessity of outpatient observation and inpatient stays, and handle concurrent denials as needed.

Strong RN background with case management preferred; requires 2+ years in utilization review or case management. This position offers hybrid work at St.