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 servicesPerform 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 Anthony's Hospital for orientationStatus: Full time, 72 hours Schedule:  1st week:  5 days 8:00 AM - 4:30 PM                      2nd week:  4 days 8:00 AM - 4:30Weekend Requirement:  Every 3rd weekendOn Call: No

 

Certifications and Licensures:

Required RN (Registered Nurse)Preferred ACM (Case Management)Preferred CCM (Case Manager)

 

Education:

Required Associates in Nursing orRequired Bachelors in NursingPreferred Masters in Nursing or Business

 

Experience:

Required 2 years in Utilization Review orRequired 2 years in Case Management orRequired 3 years Registered NursePreferred experience in Critical Care or Emergency Service

 

Benefits:

Benefits (Health, Dental, Vision)Paid time offTuition reimbursement401k match and additional yearly contributionYearly performance appraisals and team award bonusCommunity discounts and more

 

 

Equal Opportunity Employer Veterans/Disabled