Utilization Review RN: Case Management Specialist

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

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.