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Open nowPosted 126 days ago

RN, Utilization Management | Utilization Management| Variable | PRN

UF Health1,536 open roles

Where
Leesburg, Florida, United States
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Your applicationOpen nowRN, Utilization Management | Utilization Management| Variable | PRNUF Health · Leesburg, Florida, United States

  1. YouYes, apply to this one.

  2. CV RocketCV written for this posting.

  3. 25 readersRecruiter, hiring manager, skeptic. Round after round.

  4. CV RocketApplied on UF Health's own form.

The reply lands in your private mailbox

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The clock on this job

Early applications get read.

11.8% of postings close within 7 days. Measured by our own scanner across the market. UF Health postings stay open a median of 1 days.

Share of postings closed within
  1. 2.1%1 day
  2. 4.4%3 days
  3. 11.8%7 days
  4. 18.6%14 days
  5. 35.6%30 days
  6. 45.1%60 days
This job: posted 126 days ago

UF Health median: 1 days open

The posting

Overview

Make an impact by supporting the right care at the right time through utilization management excellence.

💻 Work Style: Onsite 📍 Location: Leesburg, FL 🕒 FTE: PRN (.10 FTE) ⏰ Schedule: Variable

Plays a critical role in evaluating patient medical records to ensure the necessity and appropriateness of healthcare services. Involves coordinating with healthcare providers to maintain compliance with utilization management guidelines and optimizing treatment plans for effective patient care and resource utilization. Requires clear communication of authorization decisions and ongoing monitoring to support timely discharge planning. Analyzes utilization data to identify trends and collaborates with interdisciplinary teams to enhance care coordination while ensuring accurate documentation and regulatory compliance.

Responsibilities

Key Responsibilities

  • Evaluates patient medical records to determine the medical necessity and appropriateness of healthcare services.
  • Coordinates with healthcare providers and care teams to ensure compliance with utilization management guidelines and payer requirements.
  • Supports effective treatment planning, patient care coordination, and appropriate resource utilization.
  • Communicates authorization decisions and utilization determinations while supporting timely discharge planning efforts.
  • Analyzes utilization management data and trends to identify opportunities for improved care coordination and operational efficiency.
  • Collaborates with interdisciplinary teams to ensure accurate documentation, regulatory compliance, and quality patient outcomes.

Qualifications

Education & Licensure

  • Registered Nurse (RN) with a current Florida nursing license required.

Experience & Skills

  • Minimum of three (3) years of experience in utilization review, utilization management, or case management required.
  • Knowledge of healthcare utilization guidelines, payer requirements, and regulatory compliance standards.
  • Experience evaluating medical necessity, treatment plans, and appropriate levels of care.
  • Strong communication and collaboration skills related to authorization determinations and care coordination.
  • Demonstrated ability to analyze utilization data, identify trends, and support patient care and discharge planning initiatives.
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