Utilization Reviewer, RN

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, takes action to ensure the patient is placed in the most appropriate alternative level of care, and determines the correct admission status and level of care for those patients who meet hospital admission criteria (ambulatory surgery, observation and inpatient).

Minimum Education and Experience Requirements:

• Registered nurse (RN) with current Florida license with three (3) years of critical care nursing experience, five (5) years of medical/surgical nursing experience or three (3) 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