Florida Licensed Utilization Management RN

A company is looking for a Utilization Management RN.

Key Responsibilities

Monitor admissions and perform medical necessity reviews for initial and continued stays

Collaborate with the multidisciplinary care team regarding patient status and manage concurrent denials

Ensure timely communication with insurance carriers to obtain necessary authorizations and prevent reimbursement loss

Required Qualifications, Training, and Education

Associate's degree in Nursing

3 years of clinical nursing experience

Registered Nurse (RN) license

Knowledge of state and federal guidelines pertinent to care management

Ability to navigate and utilize related software and databases for Utilization Management