Utilization Review RN

Healthcare Support Staffing; Fort Lauderdale (FL); On-site; USD 41,328 - 44,083; Full time

Benefits offered by this job

Competitive salary

Medical benefits

Positive work environment

Job summary

A national healthcare recruiting firm is seeking an experienced Registered Nurse specializing in Utilization Review for a prestigious Managed Care Company in Fort Lauderdale, Florida. This role involves conducting medical necessity reviews, collaborating with healthcare professionals, and ensuring timely admissions. The ideal candidate will have over 3 years of experience in Utilization Review and a passion for delivering quality care. Competitive salary ranging from $30 to $32 per hour, along with benefits, is offered.

Qualifications

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

Responsibilities

• Conducts pre-admission, concurrent, and retrospective reviews for medical necessity.
• Performs case reviews and documents in the appropriate database.
• Collaborates with physicians and patients to ensure quality of care.
• Completes admission reviews within specified timeframes.
• Provides outpatient or pharmacy services utilization review.

Skills

Utilization Review

Case Management

Critical Thinking

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

Are you an experienced Registered Nurse with Utilization Review or Concurrent Review experience looking for a new opportunity with a prestigious Managed Care Company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions – this is the position for you!

Daily Responsibilities:

• 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

Hours for this Position:

• M-F 8:00am to 5:00pm
  

Requirements:

• 2+ 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

Advantages of this Opportunity:

• Competitive salary ($30/hr. to $32/hr.)
  
• Benefits offered, Medical, Dental, and Vision
• Fun and positive work environment

Interested in being considered?

If you are interested in being considered for this position, PLEASE click the APPLY NOW button!