Utilization Review Nurse | Corporate Utilization Management | PRN | Variable

apartment UF Health location_onLeesburg, FL 34748, US

Overview

FTE-.10 PRN

Variable shift

The Utilization Review Nurse is responsible for evaluating the appropriateness of hospital admissions, resource utilization, and medical necessity for continued stays. This role facilitates timely discharges, ensures medical documentation accurately reflects patient severity of illness, and provides appropriate interventions and discharge planning services in collaboration with Case Management. Performs other related duties as assigned.

Qualifications

Education

Associate’s Degree required
Professional Certification in Case Management (CM) preferred

Licensure/Certification/Registration

Current Florida nursing license required
Case Management (CM) certification preferred

Special Skills, Qualifications, and Experience

Ability to read, write, speak, and understand English
Minimum of five (5) years of clinical experience
Current working knowledge of utilization management, performance improvement, and reimbursement issues preferred
Experience in utilization review, case management, appeals, denials, and managed care contracting preferred
Strong observation, analytical, and problem-solving skills
Excellent written and verbal communication skills
Ability to effectively communicate with physicians, patients/clients, families, and interdisciplinary staff

Share this job

Related Jobs

Manager/Supervisor

Part-time

Weekend Supervisor, RN

apartment Aviata at Colonial Lakes location_onWinter Garden, FL

Aviata health Group is looking for qualified Weekend RN Supervisor to join our family! Do you thrive in a family/team environment and desire to make a difference in the lives of others while advancing your skills? Are you caring and compassionate? If this sounds like you, let's talk! Shift available: Every weekend (Double Shift) Benefits Pay rate: Competitive. Additional holiday pay and overtime hours may apply. Phone and auto discounts: Up to 20% on employee personal wireless accounts and auto rentals through designated vendors. Health insurance for the entire family! 401k with a match! Major Responsibilities Supervises staff and oversees patient care in accordance with standards of care and practice and applicable state/federal regulations. Follows established facility policies and procedures while providing and coordinating resident care with other facility personnel. Supervises Certified Nursing Assistants during shift including assigning and distributing work, performance management, training new staff, and ensuring work is being performed according to facility standards. Other duties as assigned. Qualifications Must possess a current, unencumbered, active state license to practice as an RN. Experience in Skilled Nursing/Rehabilitation facilities preferred. You must be qualified, compassionate, and dedicated to a job well done. We're an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, or disability status.

Per Diem

Registered Nurse, RN

apartment SYNERGY HomeCare of Winter Garden location_onWinter Garden, FL

*Per Diem RN position open for Synergy HomeCare of Winter Garden Experience the SYNERGY HomeCare difference, where we are united under one purpose, to bring wholehearted, life-energizing care to as many people as possible - on their own terms, in their own homes. And that starts with compassionate caregivers like YOU! When you join the SYNERGY HomeCare team as an RN, you will feel appreciated, recognized, and rewarded for the comforting, life-affirming care that comes right from your heart! Our promise to our clients is to bring the full support for fuller lives and to elevate their confidence knowing they have an RN like you by their side. Do you: Enjoy serving others? Have a big heart with a lot of love to share? Take charge with a warm smile? Love your job as a registered nurse? We have an opening for a registered nurse who can answer yes to these questions. At SYNERGY HomeCare we create a world of care at home for all, which means you will have the opportunity to care for a wide variety of people; spanning all ages and all abilities. We are seeking an RN to join our independently owned and operated national agency. SYNERGY HomeCare offers: Competitive pay Direct deposit Paid orientation and ongoing training Time-and-a-half pay for overtime and holidays Flexible schedules Employee recognition programs As a Registered Nurse with SYNERGY HomeCare, you will: Assess clients and make recommendations for care planning Assist with employee training as needed, utilizing your expertise as a registered nurse Establish communication and a professional relationship with clients, family members, and co-workers Provide reliable care as a professional RN RN Benefits include: Competitive pay Direct deposit Paid orientation and ongoing training Time-and-a-half pay for overtime and holidays Flexible schedules Employee recognition programs If you would like to join our outstanding team as a registered nurse at SYNERGY HomeCare, apply today & email resume to aneerashirazee@synergyhomecare.com .

Full-time

Registered Nurse (RN)

apartment Aviata at Colonial Lakes location_onWinter Garden, FL

Aviata Health Group is looking for qualified Licensed RN's to join our family! Do you thrive in a family/team environment and desire to make a difference in the lives of others while advancing your skills? Are you caring and compassionate? If this sounds like you, let's talk! New grads are always welcome! Shifts available: Full time, PT & PRN: 7a-7p| 7p-7a Benefits Pay rate: Competitive. Additional holiday pay and overtime hours may apply. 401k with a match Health insurance for the entire family! Perfect Punch Program; $225 bi-weekly bonus. Major Responsibilities Supervises staff and oversees patient care in accordance with standards of care and practice and applicable state/federal regulations. Follows established facility policies and procedures while providing and coordinating resident care with other facility personnel. Supervises Certified Nursing Assistants during shift including assigning and distributing work, performance management, training new staff, and ensuring work is being performed according to facility standards. Other duties as assigned. Qualifications Must possess a current, unencumbered, active state license to practice as an RN. Experience in Skilled Nursing/Rehabilitation facilities preferred. You must be qualified, compassionate, and dedicated to a job well done. We're an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, or disability status.

Full-time

RN, Staff Development Coordinator, (SDC)

apartment Aviata at Colonial Lakes location_onWinter Garden, FL

Aspir eHealth Group is looking for a qualified RN Staff Development Coordinator - SDC to join our family! We are searching for an to join our community that is resident & family focused, a team builder, and excited about the opportunity to assist in building a facility culture. Are you team-oriented, driven, and excited about the opportunity to build a facility culture, then we have the perfect opportunity for you! Benefits Pay rate: Competitive salary, along with holiday pay and paid time off.. Innovative Purchasing Program: We offer a purchasing program that allows you to buy thousands of products (technology, furniture, clothing, etc.) and pay over time. Zero interest, no credit check, no hidden fees. Access to online learning 24/7: Use it for free to help satisfy your state specific licensure requirements. Phone and auto discounts: Up to 20% on employee personal wireless accounts and auto rentals through designated vendors. Major Responsibilities Provide ongoing education, mentorship, and leadership development to clinical management and clinicians, and other team members. Actively participate in the development and achievement of nursing department goals and objectives including staff development functions/responsibilities and educational programming. Assist in the implementation of and monitor compliance with policies, procedures, and standards of practice consistent with corporate and external regulatory guidelines. Recruit, hire and retain qualified nursing staff to deliver efficient resident care in accordance with the established staffing plan and state mandated staffing requirements. Collaborate with various department heads to promote positive interdepartmental relations. Assist in the development, implementation, and monitoring of an accurate and effective documentation system. Provide direct resident care as staffing patterns demand. Assure effective interaction with resident and families. Provide innovative, responsible healthcare with the creation and implementation of new ideas and concepts that continually improve systems and processes to achieve superior results. Qualifications Must possess a current, unencumbered, active state license to practice as a Registered Nurse (RN). Must possess, as a minimum, an RN Nursing Degree from an accredited college or university. Must possess a current CPR certification. Must have a minimum of three (3) years of nursing experience in a setting serving the same age/type of resident population. Minimum of one (1) year of management experience required. Must possess knowledge of local, state, and federal regulations pertaining to facility function. You must be qualified, compassionate, and dedicated to a job well done. We're an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, or disability status.

Per Diem

Registered Nurse - Pool Per Diem - OR Circulator - Horizon West

apartment Orlando Health location_onWinter Garden, FL

Position Summary Department : Surgery Shift: Day Shift / Pool Per Diem Location: Horizon West Title: Advanced Care, RN Summary: Administers patient care in an area in a hospital or inpatient setting where patients have an advanced illness or injury that routinely requires timely, intense, and complex care to stabilize and support the patient’s medical condition. These areas require a lower caregiver-to-patient ratio and highly trained team members with advanced skills. “Orlando Health Is Your Best Place to Work” is not just something we say, it’s our promise to you.” Orlando Health proudly embraces and honors the individuality of our team members. By sharing different ideas and perspectives and working together as a team, we are better able to relate to, care for and authentically serve our patients and families who make up the collective populations in our community. So, no matter who you are, what you believe or how you express yourself, you are welcome here. ORLANDO HEALTH - BENEFITS & PERKS: Competitive Pay Evening, nights, and weekend shift differentials offered for qualifying positions. All Inclusive Benefits (start day one) Student loan repayment, tuition reimbursement, FREE college education programs, retirement savings, paid paternity leave, fertility benefits, back up elder and childcare, pet insurance, PTO/Holidays, and more for full time and part time employees. Forbes Recognizes Orlando Health as a Best-In-State Employer Forbes has named Orlando Health as one of America's Best-In-State Employers for 2021. Orlando Health is the top healthcare organization in the Metro Orlando area to make the prestigious list. "We are proud to be named once again as a best place to work," said Karen Frenier, VP (HR). "This achievement reflects our positive culture and efforts to ensure that all team members feel respected, supported and valued. Employee-centric Orlando Health has been selected as one of the “Best Places to Work in Healthcare” by Modern Healthcare. Responsibilities Essential Functions Demonstrates critical knowledge, skills, and judgement to care for patients requiring complex assessment and therapies, high intensity interventions, and high-level continuous nursing vigilance. Utilizes information and assessment data to anticipate and respond with confidence and adapt to rapidly changing patient conditions. Identifies and prioritizes information to take immediate and decisive evidence-based, patient focused action. Monitors and adjusts specialized equipment used on patients, and interprets and records electronic displays, such as intracranial pressures, central venous pressures, pulmonary artery pressures, and cardiac rhythms from cardiac monitors, respirators, ventilators, oxygen pumps, etc. Responds to life-saving situations based on nursing standards and protocol. Observes, monitors, and assesses patients’ condition, recognizes, identifies, and interprets serious situations and calls Physician or takes preplanned emergency measures when Physician is not immediately available. Assesses patient’s needs and develops/revises an individualized plan of care based on patient needs and responses. Evaluates the patient’s progress toward attaining expected outcomes. Respects diversity by building respectful relationships with all team members and customers. Functions as a patient and family advocate. Demonstrates advanced knowledge and skills necessary to provide care appropriate to the age of the patients served on his or her assigned unit/ department. Serves as a preceptor, charge nurse, unit educator, and/ or nurse clinician. Communicates and collaborates with medical staff and interdisciplinary team to effectively plan and manage the unit/department. Serves as a role model for staff and supports the hospital and nursing department’s goals and strategies. Demonstrates knowledge of the principles of growth and development over the life span, assesses the data reflective of the patient’s status, and interprets the necessary information needed to identify each patient’s requirements relative to his or her age specific needs. Coordinates the care and delegates as appropriate to other team members on a defined group of patients. Documents patient care in a knowledgeable, skillful, and consistent manner meeting all required and regulatory standards. This includes but is not limited to patient assessment, education, medication administration, treatments, and patient safety. Demonstrates competency in nursing skills and use of patient care/unit equipment as defined by unit/department-specific requisite skills. Prioritizes patient care in an ongoing manner in accordance with Evidence-Based Practice Standards of Care. Practices effective problem identification and resolution. Delegates tasks and duties to healthcare team members in accordance with the patient’s needs and the team member’s capabilities and qualifications. Communicates appropriate information regarding patient condition or unit concerns to other health care team members. Demonstrates caring practices by providing a compassionate and therapeutic environment for patients and their families. Demonstrates awareness of legal issues and patients’ rights. Collaborates with the education department and nursing leadership team to effectively transition and support new team members and/or students. Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA, and other federal, state, and local standards. Maintains compliance with all Orlando Health policies and procedures Other Related Functions The professional nurse contributes to the knowledge and skills of others, and the continuous improvement of the quality of health care practice and organizational outcomes Participates and may lead unit level and/or organizational level committees of nursing practice and performance improvement. Participates in department and organizational peer review, mentoring, and coaching regarding professional practice or role performance. Practices efficient use of supplies and maintains a clean, safe, and organized work area. Attends staff development in-services, department meetings, and/or nursing committee meetings. Partners with the nursing leadership team to identify professional development needs. Assumes responsibility for one’s own professional development and continuing education. Performs all other duties as assigned. Qualifications Education/Training • Graduate of an approved school of nursing. • Meets all mandatory, developmental, and performance competency requirements for Orlando Health and unit/department. Licensure/Certification • Maintains current State of Florida RN license or valid eNLC multistate RN license • Maintains current BLS/Healthcare Provider certification. • ACLS, NRP, PALS, TNCC are required for certain areas. NRP required for Neonatal Intensive care Unit (NICU). Experience • Must have MIN. 1 year experience required in Surgery setting.