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 remotely, collaborating with healthcare teams to optimize patient care and reimbursement while adhering to regulatory standards.
Key responsibilities
- Perform hospital admission reviews to determine medical necessity and appropriate patient status
- Conduct continued stay reviews using approved clinical criteria and guidelines
- Communicate review findings and recommendations to physicians and case management staff
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, with a Bachelor's of Science in Nursing (BSN) preferred
- Experience with acute admission reviews and continued stay reviews
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