Utilization Review Nurse

Healthcare Support Staffing; Fort Lauderdale (FL); On-site; USD 39,743 - 43,050; Full time

Benefits offered by this job

Excellent Medical benefits

Dental benefits

Vision benefits

401k

PTO

Job summary

A leading healthcare recruiting firm is seeking a qualified professional to conduct utilization reviews in Fort Lauderdale, FL. The ideal candidate will have a minimum of 3 years of experience in medical/surgical or critical care, as well as utilization review and case management. Responsibilities include conducting pre-admission reviews and collaborating with healthcare teams to ensure quality care. The hourly rate ranges from $28.85 to $31.25 based on experience, accompanied by excellent medical benefits.

Qualifications

• 3+ years in recent medical/surgical or critical care experience.
• 3+ years of Utilization Review / Case Management experience.
• Strong reasoning ability to define problems and draw conclusions.

Responsibilities

• Conducts pre-admission and retrospective reviews for medical necessity.
• Performs case reviews and completes required documentation.
• Collaborates with healthcare teams for continuity and quality of care.
• Timely completion of admission reviews.
• Provides outpatient utilization review.

Skills

Medical/surgical experience

Utilization Review

Case Management

Strong reasoning ability

Job description

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Job Description

• Conducts pre-admission, concurrent and retrospective acute care, sub-acute, hospice, qualification of transitional care and long-term care needs for medical necessity
• Perform case reviews and complete all required documentation in appropriate database
• Collaborate with primary or attending physician, case managers, patient and/or family to provide continuity and quality of care in the most cost-effective manner.
• Timely completion of admission reviews (within 48-hours for weekday, 72-hours for weekend)
• Provide outpatient or pharmacy services utilization review

Qualifications

• 3+ years in recent medical/surgical or critical care experience
• 3+ years of Utilization Review / Case Management experience
• Strong reasoning ability: define problems, collect data, establish facts, and draw conclusions

Additional Information

Hours for this Position:

• M-F 8-5
  

Advantages of this Opportunity:

• $28.85/hr - $31.25/hrpending experience
• Excellent Medical benefits Offered, Medical, Dental, Vision, 401k, and PTO