Utilization Review Nurse | Corporate Utilization Management | PRN | Variable

UF Health; Leesburg (FL); On-site; USD 71,200 - 127,200; Full time

Job summary

A healthcare institution in Leesburg, Florida is seeking a Utilization Review Nurse to assess hospital admissions and resource utilization. The role involves ensuring timely patient discharges and upholding accurate medical documentation. The ideal candidate will possess an Associate's Degree, a Florida nursing license, and a minimum of five years of clinical experience. This PRN position offers competitive pay ranging from $71,200 to $127,200 based on location and experience.

Qualifications

• 5+ years of clinical experience required.
• Current Florida nursing license required.
• Professional Certification in Case Management preferred.

Responsibilities

• Evaluate appropriateness of hospital admissions and resource utilization.
• Facilitate timely discharges and ensure accurate medical documentation.
• Provide appropriate interventions and discharge planning services.

Skills

Clinical experience

Observation skills

Analytical skills

Problem-solving skills

Communication skills

Education

Associate's Degree

Job description

Utilization Review Nurse | Corporate Utilization Management | PRN | Variable – UF Health

Overview

FTE‑.10 PRN

Variable shift

The Utilization Review Nurse is responsible for evaluating the appropriateness of hospital admissions, resource utilization, and medical necessity for continued stays. This role facilitates timely discharges, ensures medical documentation accurately reflects patient severity of illness, and provides appropriate interventions and discharge planning services in collaboration with Case Management. Performs other related duties as assigned.

Qualifications

• Associate’s Degree required
• Professional Certification in Case Management (CM) preferred

Licensure/Certification/Registration

• Current Florida nursing license required
• Case Management (CM) certification preferred

Special Skills, Qualifications, And Experience

• Ability to read, write, speak, and understand English
• Minimum of five (5) years of clinical experience
• Current working knowledge of utilization management, performance improvement, and reimbursement issues preferred
• Experience in utilization review, case management, appeals, denials, and managed care contracting preferred
• Strong observation, analytical, and problem‑solving skills
• Excellent written and verbal communication skills
• Ability to effectively communicate with physicians, patients/clients, families, and interdisciplinary staff

Seniority Level

Mid‑Senior level

Employment Type

Full-time

Job Function

Health Care Provider

Industries

Hospitals and Health Care

Salary ranges by location:
Villages, FL: $80,000.00‑$85,000.00
Apopka, FL: $70,000.00‑$80,000.00
Leesburg, FL: $71,200.00‑$127,200.00
Clermont, FL: $75,000.00‑$85,000.00