Full employer posting
At BayCare, we are proud to be one of the largest employers in the Tampa Bay area. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. With the support of more than 30,000 team members, we promote a forward-thinking philosophy that’s built on a foundation of trust, dignity, respect, responsibility and clinical excellence.
The Utilization Review Specialist Senior responsibilities include: Functions as the primary liaison between the funding agents and all other related parties to ensure appropriate level of care through comprehensive concurrent review for medical necessity of outpatient observation and inpatient stays and the utilization of ancillary services Perform other duties as assigned by the supervisor including but not limited to processing concurrent denials.
Preferred experience includes Critical Care or Emergency Nursing RN. Position details: Location: Hybrid - St Josephs Hospital - Tampa, FL Orientation: full time and onsite for up to 2 months Status: PRN, As Needed
8:00 AM - 4:30. Looking for weekday availability and every 3rd weekend Some Weekdays and every 3rd weekend availability On Call: No Certifications and Licensures: Required RN (Registered Nurse) Preferred ACM (Case Management) Preferred CCM (Case Manager)
Required Associates in Nursing or Required Bachelors in Nursing Preferred Masters in Nursing or Business
Required 2 years in Utilization Review or Required 2 years in Case Management or Required 3 years Registered Nurse Preferred experience in Critical Care or Emergency Service
Benefits (Health, Dental, Vision) Paid time off Tuition reimbursement 401k match and additional yearly contribution Yearly performance appraisals and team award bonus Community discounts and more Equal Opportunity Employer Veterans/Disabled
About the role
Functions as the primary liaison between the funding agents and all other related parties to ensure appropriate level of care through comprehensive concurrent review for medical necessity of outpatient observation and inpatient stays and the utilization of ancillary services