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Utilization Review Specialist RN

BayCare Health System

Tampa, FL · HybridFull-timeSeen 3 days agoSeen in employer's feed 3 days ago

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At a glance

Compensation
No compensation found
Location
Tampa, FLHybrid
Schedule
Full-time
Work Authorization
Not specified

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Requirements

Credentials this posting asks for.

RN LicenseAssociate's degree

Job overview

BayCare Health System seeks a Utilization Review Specialist RN to act as the primary liaison between funding agents and care teams, ensuring appropriate level of care through concurrent review of outpatient observation, inpatient stays, and ancillary services, while handling denials and supporting the team in a hybrid Tampa location.

Skills & qualifications

RequiredNice to have

Skills

Utilization ReviewCase ManagementCritical CareEmergency Service

Qualifications

RN LicenseACM CertificationCCM CertificationAssociates in NursingBachelors in NursingMasters in Nursing or Business2 Years Utilization Review Experience2 Years Case Management Experience3 Years Registered Nurse ExperienceCritical Care or Emergency Service Experience

Benefits

Medical Insurance
Dental Insurance
Vision Insurance
Paid Time Off
Tuition Assistance
401(k) Match

Full job description

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.

The Utilization Review Specialist Senior responsibilities include:

  • 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.

  • Preferred experience includes Critical Care or Emergency Nursing RN.

Position details:

  • Location: Hybrid. St Josephs Hospital - Tampa, FL

  • Status: Full Time, Exempt

  • Schedule: Monday - Friday 8:00 AM - 4:30 PM

  • Weekend Requirement: 3 weekend days per month (week days will adjusted on those weeks)

  • On Call: No

Certifications and Licensures:

  • Required RN (Registered Nurse)

  • Preferred ACM (Case Management)

  • Preferred CCM (Case Manager)

Education:

  • Required Associates in Nursing or

  • Required Bachelors in Nursing

  • Preferred Masters in Nursing or Business

Experience:

  • Required 2 years in Utilization Review or

  • Required 2 years in Case Management or

  • Required 3 years Registered Nurse

  • Preferred experience in Critical Care or Emergency Service

Benefits:

  • Benefits (Health, Dental, Vision)

  • Paid time off

  • Tuition reimbursement

  • 401k match and additional yearly contribution

  • Yearly performance appraisals and team award bonus

  • Community discounts and more

Equal Opportunity Employer Veterans/Disabled

Position Utilization Review Specialist RN

Location Tampa:St Josephs | Clinical | Full Time

Req ID 174469

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