Current jobs related to Utilization Review Nurse-Utilization Review-Days - Leesburg FL United States - UF Health-Central Florida
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Utilization Review Nurse Utilization Review Days
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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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RN - Utilization Review
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Tumwater, WA, United States Providence Full timeDescription The Utilization Review (UR) Nurse has a strong clinical background blended with well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination. This individual supports the UM program by developing and maintaining effective, efficient processes for determining the appropriate...
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RN - Utilization Review
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RN - Utilization Review
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Senior Director of Utilization Review
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Utilization Review Nurse Registered Nurse
1 week ago
Winston-Salem, NC, United States Novant Health Full timeOverviewThe Utilization Review RN serves as a leader resource in the Utilization Review process. They collaborate with physicians and other members of the healthcare team to promote and adhere to regulatory compliance. The UR RN coordinates and conducts initial, concurrent, and retrospective medical necessity reviews. All Utilization Review activities are...
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Utilization Review Nurse Registered Nurse
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Winston Salem, NC, United States Novant Health Full timeOverview The Utilization Review RN serves as a leader resource in the Utilization Review process. They collaborate with physicians and other members of the healthcare team to promote and adhere to regulatory compliance. The UR RN coordinates and conducts initial, concurrent, and retrospective medical necessity reviews. All Utilization Review activities are...
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RN Utilization Review Specialist
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Utilization Review Nurse-Utilization Review-Days
2 months ago
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 requiredLicensure/Certification/Registration:- Current Florida nursing license requiredSpecial 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
