Utilization Review RN - Hybrid, Critical Care Focus

BayCare Health System; Tampa (FL); Hybrid; USD 85,000 - 110,000; Full time

Benefits offered by this job

Health insurance

Dental coverage

Vision coverage

PTO

Tuition reimbursement

401k match

Job summary

BayCare Health System is seeking a Senior Utilization Review Nurse in Tampa for a hybrid role at St. Joseph's Hospital. The position is full-time and onsite for up to two months, with ongoing PRN schedule requirements including weekday and every third weekend, 8:00 AM–4:30 PM, and no on-call duties.

Required RN licensure (Assoc/BSN), with preferred ACM/CCM credentials and 2–3 years in Utilization Review or Case Management. Experience in Critical Care or Emergency Service is a plus.

Qualifications

• 2+ years in Utilization Review or Case Management.
• 3 years RN experience.
• Preferred experience in Critical Care or Emergency Service.

Responsibilities

• Acts as primary liaison between funding agents and related parties for medical necessity of outpatient observation, inpatient stays and services.
• Processes concurrent denials and other duties as assigned by supervisor.
• Supports RN in critical care or emergency settings as needed.

Skills

Utilization review

Case management

Nursing

Education

Associates in Nursing

Bachelors in Nursing

Masters in Nursing or Business

Job description

BayCare Health System is seeking a Senior Utilization Review Nurse in Tampa for a hybrid role at St. Joseph's Hospital. The position is full-time and onsite for up to two months, with ongoing PRN schedule requirements including weekday and every third weekend, 8:00 AM–4:30 PM, and no on-call duties.

Required RN licensure (Assoc/BSN), with preferred ACM/CCM credentials and 2–3 years in Utilization Review or Case Management. Experience in Critical Care or Emergency Service is a plus.