Utilization Review Registered Nurse

Are you a passionate and dedicated Registered Nurse looking for a rewarding career opportunity? Look no further than Baptist Health South Florida! We are currently seeking a Utilization Review Registered Nurse to join our team and play a vital role in ensuring the delivery of high-quality healthcare services to our patients. As a Utilization Review RN, you will utilize your clinical expertise to review and assess the appropriateness and efficiency of medical services provided to our patients. The ideal candidate will possess strong critical thinking skills, excellent communication abilities, and a commitment to providing exceptional patient care. If you meet the qualifications listed below, we encourage you to apply for this exciting opportunity and become part of our dynamic healthcare team.

1. Conduct utilization reviews to determine the appropriateness and efficiency of medical services provided to patients.
2. Utilize clinical expertise to assess patient needs and make recommendations for appropriate care plans.
3. Communicate with healthcare providers and insurance companies to ensure proper utilization and reimbursement for medical services.
4. Maintain accurate and detailed records of patient assessments, referrals, and care plans.
5. Collaborate with interdisciplinary teams to develop and implement strategies for improving patient care and outcomes.
6. Stay up-to-date on industry regulations and guidelines related to utilization review.
7. Educate and train healthcare staff on proper utilization review processes and procedures.
8. Advocate for patients to receive the best care possible while also managing costs for the healthcare organization.
9. Identify areas for process improvement and make recommendations to enhance efficiency and quality of care.
10. Provide support and guidance to patients and their families, addressing any questions or concerns related to utilization review.
11. Participate in quality improvement initiatives to maintain high standards of patient care.
12. Adhere to all ethical and legal standards related to patient confidentiality and privacy.
13. Collaborate with insurance companies and other third-party payers to ensure timely and accurate reimbursement.
14. Maintain a positive and professional demeanor while interacting with patients, families, and colleagues.
15. Attend trainings and conferences to stay current on best practices and new developments in the field of utilization review.

According to JobzMall, the average salary range for a Utilization Review Registered Nurse in Boca Raton, FL, USA is $71,000 to $90,000 per year. This can vary depending on factors such as experience, education, and the specific employer. Some employers may offer higher salaries or additional benefits such as bonuses or healthcare benefits.

Baptist Health South Florida is a faith-based, not-for-profit healthcare organization and clinical care network in southern Florida. It operates seven hospitals, about fifty outpatient and urgent care centers, as well as several community health and outreach programs.