Utilization Review RN – Hybrid, Impact & Case Management

BayCare Health System; Tampa (FL); Hybrid; USD 85,000 - 105,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Paid time off

Tuition reimbursement

401k match

Job summary

BayCare Health System in Tampa, FL seeks a Utilization Review Senior Registered Nurse to liaise between funding agents and care teams, ensuring medical necessity for outpatient observation and inpatient stays.

The hybrid, full-time role at St. Joseph's Hospital requires RN licensure and 2+ years in utilization review or case management, with preferred experience in critical care or emergency services. Benefits include health/dental/vision, PTO, tuition reimbursement and a 401(k) match.

Qualifications

• Requires RN licensure with 2+ years in utilization review or case management.
• Experience in Critical Care or Emergency Nursing preferred.
• Hybrid role at St Josephs Hospital in Tampa.

Responsibilities

• Functions as liaison between funding agents and care teams to ensure medical necessity for outpatient observation and inpatient stays.
• Perform concurrent reviews for outpatient and inpatient stays and utilization of ancillary services.
• Process concurrent denials as assigned by supervisor.
• Collaborate with care teams to optimize utilization and discharge planning.

Skills

RN

Case Management

Utilization Review

Education

Associates in Nursing

Bachelors in Nursing

Masters in Nursing or Business

Job description

BayCare Health System in Tampa, FL seeks a Utilization Review Senior Registered Nurse to liaise between funding agents and care teams, ensuring medical necessity for outpatient observation and inpatient stays.

The hybrid, full-time role at St. Joseph's Hospital requires RN licensure and 2+ years in utilization review or case management, with preferred experience in critical care or emergency services. Benefits include health/dental/vision, PTO, tuition reimbursement and a 401(k) match.