Utilization Reviewer-NE | Utilization Management | Part time | Day shift - at UF Health

Gainesville, Florida, United States -

Full Time

Start Date

Immediate

Expiry Date

15 Feb, 26

Salary

0.0

Posted On

17 Nov, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Critical Care Nursing, Medical-Surgical Nursing, Utilization Management, Case Management, Organizational Skills, Attention to Detail, Problem-Solving, Interpersonal Skills, Communication Skills, Independent Work, Collaborative Work, Priority Adjustment, Patient-Centered Care, Admission Reviews, Concurrent Reviews, Level of Care Determination

Industry

Hospitals and Health Care

Description

Overview The role supports the hospital healthcare team in delivering high-quality, efficient, patient-centered care. It serves as a key resource for physicians by conducting admission and concurrent reviews. The position involves identifying patients who do not meet criteria for the current level of care, taking appropriate action to ensure they are placed in the most suitable alternative level of care, and determining the correct admission status and level of care for patients who meet the hospital's admission criteria (including ambulatory surgery, observation, and inpatient care). Qualifications Minimum Education and Experience Requirements: Education: Registered Nurse (RN) with a current Florida license. Experience: Three (3) years of critical care nursing experience, OR five (5) years of medical-surgical nursing experience, OR three (3) years of utilization/case management or third-party payer work experience. Skills & Abilities: Ability to adjust priorities quickly and effectively. Strong organizational skills with the ability to manage multiple tasks simultaneously. Ability to work independently and collaboratively with staff at all levels. Excellent attention to detail. Strong organizational, interpersonal, and communication skills. Innovative problem-solving abilities. Work Hours & Flexibility: Scheduled work hours and days may vary depending on departmental needs as determined by the department director/manager. Motor Vehicle Operator Designation: Employees in this position will not operate vehicles for assigned business purposes. Note: A "frequent driver" is defined as someone who uses a personal or Shands vehicle: At least once daily, At least five (5) individual trips per week, or Drives, on average, over 150 miles per week in the performance of their job. Please ensure the appropriate operator designation is indicated on the Request for Personnel (RFP) form when submitting the position request. Licensure/Certification/Registration: Current Registered Nurse (RN) license in Florida.

Responsibilities

The role involves supporting the healthcare team by conducting admission and concurrent reviews. It includes identifying patients who do not meet criteria for their current level of care and ensuring they are placed in the appropriate alternative level of care.