Utilization Reviewer-NE | Utilization Management | PRN | Shift

Job Overview:

The role supports the hospital healthcare team in delivering high-quality, patient-centered care. It serves as a key resource for physicians by conducting admission and concurrent reviews, ensuring patients are placed in the most appropriate level of care. This includes identifying patients who do not meet criteria and taking necessary action to transition them to an alternative care level. Additionally, the position determines the correct admission status for patients who meet hospital criteria, including ambulatory surgery, observation, and inpatient care.

• Education:

  • Registered Nurse (RN) with a current Florida license.

• Experience:

  • Three (3) years of critical care nursing experience,

  • OR five (5) years of medical-surgical nursing experience,

  • OR three (3) years of utilization/case management or third-party payer work experience.

• Skills and Abilities:

  • Ability to quickly adjust priorities and manage multiple tasks simultaneously.

  • Strong organizational skills with a keen attention to detail.

  • Ability to work both independently and collaboratively with various levels of staff.

  • Excellent interpersonal and communication skills.

  • Strong problem-solving abilities and innovative thinking.

• Work Hours & Flexibility:

  • Scheduled work hours and days may vary depending on departmental needs as determined by the department director/manager.

• Employees in this position will not be required to operate vehicles for business purposes.

Note: A "frequent driver" is defined as someone who uses a personal or Shands vehicle:

• At least once daily
  ,

• At least five (5) individual trips per week
  , or

• Drives, on average, over 150 miles per week in the performance of their job.

Please ensure the appropriate operator designation is indicated on the Request for Personnel (RFP) form when submitting the position request.

• Registered Nurse (RN) with a current Florida license.