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Utilization Management Review Nurse in Tampa, FL at Accounting Now

Date Posted: 5/22/2023

Job Snapshot

  • Employee Type:
    Contract to Hire
  • Location:
    Tampa, FL
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
  • Job ID:
  • Remote

Job Description

The Utilization Management Nurse will utilize clinical knowledge, communication skills, and analytical skills to interpret criteria, policies, and procedures to ensure the best and most appropriate treatment, care or services for members. Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment.
  • Perform acute concurrent front-end reviews to determine medical necessity.
Must be willing to comply with the following:
  • Florida RN license or Compact License without disciplinary action
Required Qualifications
  • Licensed Registered Nurse (RN) in Florida license or compact license with no disciplinary action.
  • 3 or more years experience preferably in an acute care- inpatient hospital setting.
  • Intermediate or better working using Microsoft Word, Outlook and Excel
  • Bachelor's degree
  • Front End Review experience
  • Previous experience in Utilization Management
  • Health Plan experience
  • Previous Medicare/Medicaid Experience
Workstyle: Remote Work at Home
Location: Supporting Central or Eastern Time