Utilization Reviewer-NE | Utilization Management | PRN | Variable 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, Interpersonal Skills, Communication Skills, Organizational Skills, Problem-Solving, Innovative Thinking, Attention to Detail, Collaboration, Priority Management, Patient-Centered Care, Admission Reviews, Concurrent Reviews, Care Transition

Industry

Hospitals and Health Care

Description

Overview Job Overview: The role supports the hospital healthcare team in delivering high-quality, patient-centered care. It serves as a key resource for physicians by conducting admission and concurrent reviews, ensuring patients are placed in the most appropriate level of care. This includes identifying patients who do not meet criteria and taking necessary action to transition them to an alternative care level. Additionally, the position determines the correct admission status for patients who meet hospital 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 and Abilities: Ability to quickly adjust priorities and manage multiple tasks simultaneously. Strong organizational skills with a keen attention to detail. Ability to work both independently and collaboratively with various levels of staff. Excellent interpersonal and communication skills. Strong problem-solving abilities and innovative thinking. 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 be required to operate vehicles for 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: Registered Nurse (RN) with a current Florida license.

Responsibilities

The role involves conducting admission and concurrent reviews to ensure patients receive appropriate levels of care. It also includes identifying patients who do not meet criteria and facilitating their transition to alternative care levels.