Utilization Reviewer

Full Time
Gainesville, FL 32608
Posted
Job description

Job Opening Summary

Assists the hospital health care team in maintaining quality and efficient patient-centered care. Serves as a resource to physicians, conducts admission and concurrent reviews, identifies patients who do not meet criteria and takes action to ensure the patient is placed in the most appropriate alternative level of care. Determines the correct admission status and level of care for those patients who meet hospital admission criteria (ambulatory surgery, observation and inpatient).

Job Opening Qualifications

Minimum Education and Experience Requirements:

  • Registered Nurse (RN) with current Florida license and three years of critical care nursing experience, five years of medical-surgical nursing experience or three years of utilization, case management or third-party payer work experience.
  • Ability to adjust priorities quickly.
  • Ability to organize multiple tasks simultaneously.
  • Ability to work independently.
  • Ability to work interdependently with many levels of staff.
  • Attention to detail.
  • Excellent organizational, interpersonal and communication skills.
  • Innovative problem-solving skills.
  • Scheduled work hours and days may vary depending upon departmental needs determined by department director/manager.

Licensure/Certification/Registration:

  • Registered Nurse (RN) with current Florida license.




Job Opening Qualifications

Minimum Education and Experience Requirements:
Registered nurse (RN) with current Florida license with three (3) years critical care nursing experience, five (5) years medical-surgical nursing experience or three (3) years utilization/case management or 3rd party payer work experience. Ability to adjust priorities quickly. Ability to organize multiple tasks simultaneously. Ability to work independently. Ability to work interdependently with many levels of staff. Attention to detail. Excellent organizational, interpersonal and communication skills. Innovative problem solving skills. Scheduled work hours and days may vary depending upon departmental needs determined by department director/manager.

Motor Vehicle Operator Designation:
Employees in this position:

Will not operate vehicles for an assigned business purpose

NOTE: A frequent driver is defined as one who uses his/her personal or Shands automobile a) at least once daily, b) at least five individual trips per week or c) drives, on average, over 150 miles per week in the performance of his/her job. Please indicate the appropriate operator designation on the Request for Personnel (RFP) form at the time a RFP is submitted to post the position.

Licensure/Certification/Registration:
Registered Nurse (RN) with current Florida License

Shift hours: 8 a.m. - 4:30 p.m., Monday-Friday, Occasional Weekends

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