RN - Utilization Review Specialist

2 weeks ago


Eglin Air Force Base, Florida, United States Spectrum Healthcare Resources Full time
Job Summary

Spectrum Healthcare Resources is seeking a skilled Registered Nurse to fill a Utilization Review position at Eglin Air Force Base in Florida. As a Utilization Review RN, you will play a critical role in developing and implementing a comprehensive Utilization Management plan to ensure efficient use of healthcare resources.

Key Responsibilities
  • Develop and implement a Utilization Management plan to optimize resource utilization
  • Analyze data and metrics to identify areas for improvement and cost containment
  • Monitor specialty care referrals for appropriateness and authorized procedures
  • Perform medical necessity review for planned inpatient and outpatient surgery
  • Act as referral approval authority for designated referrals
Requirements
  • Graduated from an accredited school of nursing with a Bachelor of Science in Nursing
  • Unrestricted RN license
  • One year of previous experience in Utilization Management
  • American Heart Association or American Red Cross Healthcare Provider (HCP) Certification BLS
About Spectrum Healthcare Resources

We are a Joint Commission Certified Healthcare Resource with over 35 years of experience providing innovative and cost-effective solutions for federal agencies. We are committed to delivering successful outcomes for our clients and healthcare professionals. Spectrum Healthcare Resources is an equal opportunity employer and welcomes applications from qualified candidates.



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