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Utilization Review/Outpatient Care RN

Open 59d

Job Title: Utilization Review/Outpatient Care RN

Are you an experienced Registered Nurse with Utilization Review experience looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions – this is the position for you!


Position Summary:

As the Utilization Review/Outpatient Care RN, you would be responsible for reviewing and collecting medical information in order to determine medical necessity of services requested.


Hours for this Position: Monday-Friday daytime hours (40 hours/week)


Advantages of this Opportunity:

  • Pay $28-$32 per hour, negotiable based on experience
  • Work for a prominent Healthcare company who pride themselves on partnership, integrity, teamwork, and accountability
  • Be a part of a team who serves the full spectrum of member needs
  • Weekly deposit options
  • Great benefits offered


More Insight of Daily Responsibilities:

  • Ensures that services provided to eligible members are within benefit plan
  • Initiates and continues direct communication with health care providers involved with the care of the member
  • Identifies appropriate clinical settings for services being requested
  • Identifies and refers cases appropriate for case management
  • Identifies potential quality of care issues and refers to Quality Department
  • Determines appropriate utilization management of services requested

What We Look For:

  • Clear and active RN license in state of FL
  • 2+ years of acute clinical/surgical position
  • Recent experience with utilization management

Interested in being considered in this position?

TAKE THE NEXT STEP! Click the green I'M INTERESTED button to send me your resume.

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