Florida Licensed Utilization Management RN

A company is looking for a Utilization Management RN PRN.

Key Responsibilities

Analyze patient records to assess hospital admissions, treatment legitimacy, and appropriate care levels

Facilitate precertification and payer authorization processes to prevent unnecessary denials

Collaborate with multidisciplinary teams to ensure efficient delivery of care and resolve status conflicts

Required Qualifications, Training, and Education

Current and valid RN license (ADN or BSN)

3 years of acute care clinical nursing experience

2 years of Utilization Management experience or equivalent professional experience

Familiarity with electronic health records for at least 2 years

Knowledge of state and federal guidelines related to care management