Florida Licensed Utilization Review Nurse
Job Summary
To ensure appropriate utilization of hospital resources, the full-time Florida Licensed Utilization Review Nurse will conduct admission and continued stay reviews, collaborating with interdisciplinary teams while working remotely during day shifts.
Key responsibilities
- Perform hospital admission and continued stay reviews to determine medical necessity and appropriate patient status
- Evaluate clinical documentation for compliance with payer and regulatory requirements
- Communicate findings and collaborate with physicians and case management staff on complex cases
Required qualifications
- Current, unrestricted Registered Nurse (RN) license
- Minimum five (5) years of acute care nursing experience in a hospital setting
- Minimum two (2) years of recent hospital-based utilization review experience
- Graduate of an accredited school of nursing; Bachelor's of Science in Nursing (BSN) preferred
- Certification as a Case Manager (CCM, ACM, CMCN, or CMGT-BC) preferred
Complete Job Description
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