RN Utilization Review Full-time
BayCare Health System

Utilization Review RN

apartment BayCare Health System location_onTampa, FL, US
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At BayCare, we are proud to be one of the largest employers in the Tampa Bay area. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. With the support of more than 30,000 team members, we promote a forward-thinking philosophy that’s built on a foundation of trust, dignity, respect, responsibility and clinical excellence.

The Utilization Review Specialist Senior/RN Responsibilities Include

  • Functions as the primary liaison between the funding agents and all other related parties to ensure appropriate level of care through comprehensive concurrent review for medical necessity of outpatient observation and inpatient stays and the utilization of ancillary services
  • Perform other duties as assigned by the supervisor including but not limited to processing concurrent denials.
  • Preferred experience includes Critical Care or Emergency Nursing RN.

Position Details

  • Location: HYBRID/St Josephs Hospital - Tampa, FL
  • Status: PRN, As Needed
  • Schedule: Days will Vary, Orientation will be full time and onsite
  • Weekend Requirement: Occasional
  • On Call: No

Certifications And Licensures

  • Required RN (Registered Nurse)
  • Preferred ACM (Case Management)
  • Preferred CCM (Case Manager)

Education

  • Required Associates in Nursing or
  • Required Bachelors in Nursing
  • Preferred Masters in Nursing or Business

Experience

  • Required 2 years in Utilization Review or
  • Required 2 years in Case Management or
  • Required 3 years Registered Nurse
  • Preferred experience in Critical Care or Emergency Service

Benefits

  • Tuition reimbursement
  • 401k
  • Yearly performance appraisals
  • Community discounts and more

Equal Opportunity Employer Veterans/Disabled

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