Utilization Review RN

Position Overview

At BayCare, we are proud to be one of the largest employers in the Tampa Bay area. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. With the support of more than 30,000 team members, we promote a forward-thinking philosophy that's built on a foundation of trust, dignity, respect, responsibility and clinical excellence.

Location: HYBRID/St Josephs Hospital - Tampa, FL

Status:

Weekend Requirement:

On Call:

Key Responsibilities

• Functions as the primary liaison between the funding agents and all other related parties to ensure appropriate level of care through comprehensive concurrent review for medical necessity of outpatient observation and inpatient stays and the utilization of ancillary services.
• Perform other duties as assigned by the supervisor including but not limited to processing concurrent denials.

Required Qualifications

• Qualifications: Required RN (Registered Nurse)
• Education: Required Associates in Nursing or Required Bachelors in Nursing
• Experience Required: 2 years in Utilization Review, or 2 years in Case Management, or 3 years as a Registered Nurse

Preferred Qualifications

• Preferred experience includes Critical Care or Emergency Nursing RN
• Preferred ACM (Case Management)
• Preferred CCM (Case Manager)
• Preferred Masters in Nursing or Business
• Preferred experience in Critical Care or Emergency Service

Benefits & Perks

• Tuition reimbursement
• 401k
• Yearly performance appraisals
• Community discounts and more