UF Health
Location
Gainesville, Florida
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.
Candidates must be a Registered Nurse (RN) with a current Florida license and have significant experience in critical care, medical-surgical nursing, or utilization management. Strong organizational, communication, and problem-solving skills are essential.
Registered Nurse (RN) with a current Florida license required. Three (3) years of critical care nursing experience, or Five (5) years of medical-surgical nursing experience, or Three (3) years of utilization review, case management, or third-party payer experience.
Active Registered Nurse (RN) license with 3+ years of experience in utilization review or case management. Strong knowledge of healthcare utilization management guidelines and regulatory compliance. Experience evaluating medical necessity and optimizing treatment plans. Excellent communication skills with the ability to clearly convey authorization decisions. Ability to analyze utilization data and support effective care coordination. Strong organizational skills with the ability to manage multiple priorities simultaneously. Ability to work independently and collaboratively with multidisciplinary teams. Strong attention to detail and innovative problem-solving skills. Flexibility to adjust work hours and days based on departmental needs. Motor Vehicle Operator Designation: Employees in this position will not operate vehicles for an assigned business purpose.
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