Utilization Management Rn

AdventHealth

Tampa, Florida, United States
Base: $68,132.50 - $119,520.35; bonus/equity: not ...
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Medical necessity review expertise
Payer guidelines knowledge
Concurrent authorization management
** AdventHealth is seeking a full-time Registered Nurse for Utilization Management in Tampa, Florida. The role involves monitoring patient admissions, conducting medical necessity reviews, and collaborating with healthcare teams to ensure appropriate patient status and authorization processes. **

Job Summary

  • Join a community that believes in the wholeness of each person and serves to uplift others in body, mind, and spirit.
  • The role involves monitoring admissions, performing initial and continued stay medical necessity reviews, and managing concurrent denials to prevent loss of reimbursement.
  • Benefits include medical, dental, vision, life, and disability insurance, plus 4 weeks of 100% paid parental leave starting from day one.

Matching Summary

Match Score: 75

** AdventHealth is seeking a full-time Registered Nurse for Utilization Management in Tampa, Florida. The role involves monitoring patient admissions, conducting medical necessity reviews, and collaborating with healthcare teams to ensure appropriate patient status and authorization processes. **

Salary

Base: $68,132.50 - $119,520.35; Bonus/Equity: Not specified; Benefits: Medical, Dental, Vision, Life, Disability, 403-B, Paid Parental Leave

Skills & Requirements

Must-have

  • Medical necessity review expertise
  • Payer guidelines knowledge
  • Concurrent authorization management
  • Electronic health record navigation
  • Interdisciplinary team collaboration

Nice-to-have

  • Strong analytical problem-solving skills
  • Professional growth mindset
  • Excellent negotiation communication
  • Experience with denial prevention
  • Commitment to whole person well-being

Key Requirements

  • Associate's degree in Nursing required
  • Registered Nurse (RN) license required
  • 3+ years clinical nursing experience required
  • 5+ years acute care nursing preferred
  • ACM or CCM certification preferred

Work Rights

Not specified

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