Top 3 Rn, utilization management | utilization management| day| full time Jobs in Saint Augustine, Fl

RN, Utilization Management | Utilization Management| Day| Full Time
UF Health —Saint Johns, FL
- Full-time
- RN License
- Mid-level
- 3 years
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Case Manager| Case Managerment| Day Full Time
UF Health —Saint Augustine, FL
- Full-time
- Master of Social Work
- Nursing
- RN License
14d
Registered Nurse, Clinic Manager
Premise Health —Jacksonville, FL
- Full-time
- Background check
- Nursing
- RN License
- Wellness program
- Paid holidays

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Case Manager| Case Managerment| Day Full Time
UF Health —Saint Augustine, FL
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rn, utilization management | utilization management| day| full time jobs near saint augustine, fl

RN, Utilization Management | Utilization Management| Day| Full Time

UF Health -
Saint Johns, FL

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Job Details

Full-time
7 days ago

Qualifications

RN License
Regulatory compliance
Utilization management
Resource utilization in healthcare
Cross-functional communication

Full Job Description

Overview:

The RN Utilization Management plays a critical role in evaluating patient medical records to ensure the necessity and appropriateness of healthcare services. Involves coordinating with healthcare providers to maintain compliance with utilization management guidelines and optimizing treatment plans for effective patient care and resource utilization. Requires clear communication of authorization decisions and ongoing monitoring to support timely discharge planning. Analyzes utilization data to identify trends and collaborates with interdisciplinary teams to enhance care coordination while ensuring accurate documentation and regulatory compliance

Responsibilities:

An incumbent in this position will

Evaluates patient medical records to ensure necessity and appropriateness of healthcare services.
Coordinates with healthcare providers to maintain compliance with utilization management guidelines.
Optimizes treatment plans for effective patient care and resource utilization.
Communicates authorization decisions clearly and supports timely discharge planning.
Analyzes utilization data to identify trends and improve care coordination.
Collaborates with interdisciplinary teams to ensure accurate documentation and regulatory compliance.

Qualifications:

Required: Registered Nurse (RN) with a current Florida license required.

3+ years experience in utilization review or case management
Knowledge of healthcare utilization guidelines and compliance
Experience evaluating medical necessity and treatment plans
Strong communication skills for authorization decisions
Ability to analyze utilization data and support care coordination

Licensure/Certification/Registration:

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

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rn, utilization management | utilization management| day| full time jobs in saint augustine, fl

RN, Utilization Management | Utilization Management| Day| Full Time

Case Manager| Case Managerment| Day Full Time

Registered Nurse, Clinic Manager

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