Current jobs related to Utilization Review NurseUtilization ReviewDays - Leesburg FL - UF Health-Central Florida
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Utilization Review Nurse Utilization Review Days
4 weeks ago
Leesburg, United States UF Health Full timeOverview: UF Health Leesburg Hospital has been serving the health care needs of our community for 58 years. The hospital offers advanced cardiac care including one of the largest cardiothoracic surgery programs in the state. The American College of Cardiology has recognized UF Health Leesburg Hospital for its demonstrated expertise and commitment in treating...
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Leesburg, United States UF Health Full timeOverview UF Health Leesburg Hospital has been serving the health care needs of our community for 58 years. The hospital offers advanced cardiac care including one of the largest cardiothoracic surgery programs in the state. The American College of Cardiology has recognized UF Health Leesburg Hospital for its demonstrated expertise and commitment in treating...
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Leesburg, United States UF Health Full timeOverview UF Health Leesburg Hospital has been serving the health care needs of our community for 58 years. The hospital offers advanced cardiac care including one of the largest cardiothoracic surgery programs in the state. The American College of Cardiology has recognized UF Health Leesburg Hospital for its demonstrated expertise and commitment in treating...
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Utilization Review Nurse
3 weeks ago
, FL, United States Trinity Health Full timeJob SummaryWe are seeking a skilled Utilization Review Nurse to join our team at Trinity Health. As a Utilization Review Nurse, you will play a critical role in ensuring that patients receive the most appropriate level of care while minimizing unnecessary costs.Key ResponsibilitiesReview hospital admissions to determine medical necessity and ensure...
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Utilization Review Nurse
1 month ago
, FL, United States UF Health-Central Florida Full timeJob SummaryUF Health-Central Florida is seeking a skilled Utilization Review Nurse to join our team. As a key member of our healthcare team, you will play a critical role in ensuring the appropriate use of hospital resources and medical services.ResponsibilitiesDetermine the medical necessity of hospital admissions and continued staysFacilitate timely...
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Licensed Utilization Review Specialist
2 weeks ago
Tampa, FL , USA, United States Elevance Health Full timeJob SummaryWe are seeking a highly skilled Licensed Utilization Review Specialist to join our team at Elevance Health. As a key member of our medical management team, you will play a critical role in ensuring that our members receive the most appropriate and cost-effective care possible.Key ResponsibilitiesConduct thorough reviews of medical necessity and...
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Registered Nurse RN
2 weeks ago
Pensacola, FL, United States Ascension Full timeDetails Department: Utilization Review Schedule: Full time days; 8:00AM-4:30PM Monday-Friday Hospital: Ascension Sacred Heart Pensacola Location: Pensacola, Florida Benefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term & short-term disability Employee assistance...
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Utilization Review Clinician- ABA
1 month ago
Miami, FL, United States Centene Corporation Full timeYou could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. ***POSITION IS REMOTE BUT CANDIDATE MUST RESIDE IN STATE OF FLORIDA***Position...
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Clinical Utilization Review Specialist
2 weeks ago
Tallahassee, FL, United States Centene Corporation Full timeJob Title: Utilization Review Clinician - ABAJoin Centene Corporation, a leading healthcare company, as a Utilization Review Clinician - ABA. In this role, you will play a critical part in ensuring the medical appropriateness of Applied Behavioral Analysis (ABA) services for our members.Key Responsibilities:Evaluate member care and health status before,...
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Clinical Utilization Coordinator
3 days ago
Leesburg, Florida, United States UF Health Full timeOverviewUF Health Leesburg Hospital is a leading healthcare provider in the region, offering advanced cardiac care, orthopedic surgery, and emergency services. As a Denial Recovery Coordinator, you will play a critical role in managing and coordinating utilization and external review activities related to payor issues.ResponsibilitiesUnder the general...
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Clinical Utilization Specialist
2 weeks ago
Leesburg, Virginia, United States UF Health Full timeJob Title: Utilization Review NurseUF Health Leesburg Hospital is seeking a skilled Utilization Review Nurse to join our team. As a Utilization Review Nurse, you will play a critical role in ensuring the appropriate use of hospital resources and medical services.Responsibilities:Determine the medical necessity of hospital admissions and continued...
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Utilization Review Clinician- ABA
2 months ago
Pompano Beach, FL, United States Centene Corporation Full timeYou could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. ***POSITION IS REMOTE BUT CANDIDATE MUST RESIDE IN STATE OF FLORIDA***Position...
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Utilities Project Coordinator
3 weeks ago
Leesburg, Virginia, United States Town of Leesburg, VA Full timeJob SummaryWe are seeking a highly skilled and experienced Utilities Project Technician to join our team at the Town of Leesburg, VA. As a key member of our Utilities Department, you will be responsible for managing water and sanitary sewer utility projects, including contract management, project coordination, and customer assistance.Key...
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Clinical Utilization Specialist
1 week ago
Leesburg, Virginia, United States UF Health Full timeJob SummaryThe Utilization Review Nurse is a key member of the healthcare team at UF Health Leesburg Hospital, responsible for ensuring the appropriate use of hospital resources and medical services. This role requires a strong clinical background, excellent communication skills, and the ability to analyze complex medical...
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Physician Reviewer for Disability Peer Review
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Insurance Defense Litigation Attorney
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Development Review Technician I
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Senior Attorney
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FPP Attorney
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Tampa, FL , USA, United States De Novo Review Inc Full timeJob Opportunity: De Novo Review Inc is seeking an ambitious attorney for its Tampa office, specifically for its First-Party Property division.Responsibilities:Handle a comprehensive caseload from initiation through post-trial.Participate in hearings, depositions, mediations, and trials.Draft pleadings, manage discovery and responses, file motions, and create...
Utilization Review NurseUtilization ReviewDays
2 months ago
Overview UF Health Leesburg Hospital has been serving the health care needs of our community for 58 years. The hospital offers advanced cardiac care including one of the largest cardiothoracic surgery programs in the state. The American College of Cardiology has recognized UF Health Leesburg Hospital for its demonstrated expertise and commitment in treating patients with chest pain by awarding a Chest Pain Center Accreditation with Primary PCI and Resuscitation its highest and best level of accreditation. UF Health Leesburg Hospital also offers advanced orthopedic surgery, stroke care, emergency services as well as labor and delivery care. The hospital is part of UF Health Central Florida, a not-for-profit health care system and the largest most comprehensive provider of health care services in the region. UF Health Central Florida provides inpatient acute hospital services at UF Health Leesburg Hospital and UF Health Spanish Plaines Hospital, inpatient rehabilitation services at UF Health Rehab Hospital The Villages and diagnostic laboratory services at several locations. We take pride in providing progressive, innovative technology, along with building strong relationships with patients, families, physicians and residents of the communities we serve. Responsibilities The Utilization Review Nurse is responsible for determining the appropriateness of hospital admission; utilization of resources and medical necessity for continued stay; facilitates timely discharge; assures medical documentation accurately reflects the patient's severity of illness; provides appropriate interventions and discharge planning services to the patients and families in collaboration with Case Management. Performs other duties as assigned. Qualifications Education:- Professional Certification in CM preferred- Associates Degree required Licensure/Certification/Registration:- Current Florida nursing license required Special Skills/Qualifications/Additional Training/Experience Required:- Must be able to read, write, speak and understand English- Experience: Minimum of 5 years clinical experience- Current working knowledge of Utilization management, performance improvement and reimbursement issues, preferred- Utilization review, Case Management, appeals, denials, managed care contracting experience preferred- Requires excellent observation skills, analytical thinking and problem solving as well as excellent communication skills- Effective communication skills required to facilitate contact with physicians, patients/clients, families and staff- CM certification preferred
