Utilization Review Nurse | Corporate Utilization Management | PRN

Utilization Review Nurse | Corporate Utilization Management | PRN | Variable – UF Health

FTE‑.10 PRN

Variable shift

The Utilization Review Nurse is responsible for evaluating the appropriateness of hospital admissions, resource utilization, and medical necessity for continued stays. This role facilitates timely discharges, ensures medical documentation accurately reflects patient severity of illness, and provides appropriate interventions and discharge planning services in collaboration with Case Management. Performs other related duties as assigned.

• Associate’s Degree required
• Professional Certification in Case Management (CM) preferred

• Current Florida nursing license required
• Case Management (CM) certification preferred

• Ability to read, write, speak, and understand English
• Minimum of five (5) years of clinical experience
• Current working knowledge of utilization management, performance improvement, and reimbursement issues preferred
• Experience in utilization review, case management, appeals, denials, and managed care contracting preferred
• Strong observation, analytical, and problem‑solving skills
• Excellent written and verbal communication skills
• Ability to effectively communicate with physicians, patients/clients, families, and interdisciplinary staff

Mid‑Senior level

Full-time

Health Care Provider

Hospitals and Health Care

Salary ranges by location:
Villages, FL: $80,000.00‑$85,000.00
Apopka, FL: $70,000.00‑$80,000.00
Leesburg, FL: $71,200.00‑$
Clermont, FL: $75,000.00‑$85,000.00