Registered Nurse, Utilization Management, PRN, Baptist Metro Square

Job Summary

Baptist Medical Center Jacksonville is currently hiring for a Registered Nurse to join our Utilization Management at our Metro Square location here in the Jacksonville, FL area.

The Utilization Management RN reviews charts assisting to determine correct patient class (inpatient, obs, outpatient) to ensure proper billing. The RN uses regulatory information from CMS, Medicaid as well as tools to determine medical necessity for admission and continued stay. The RN interacts with physicians, insurance carriers and nursing staff to obtain and provide information

As a Utilization Management RN, you will be responsible for:

• Concurrent monitoring of patient record documentation to verify the need for hospitalization.
• Appropriate utilization of resources and assist with documentation improvement.
• Ensuring that the UR Plan is carried out in accordance with all QIO/PRO mandates and government regulations.
• Providing utilization information to commercial carriers per contractual arrangement.
• Assisting with discharge planning and case management activities.

This Nurse, Utilization Management will be located at Baptist Jacksonville. If you are interested in this PRN opportunity, please apply now!

Education Required

Associate's Degree - Nursing

Education Preferred

Bachelor's Degree

Experience

• 3-5 Years Case Management Experience

License and Certification

• Licensed Registered Nurse Required

Location

Location Overview

Baptist Health, founded in 1955, is North Florida’s most comprehensive health care system and the area’s only non-profit, mission-driven, locally governed health care provider. Baptist Health has over 200 points of care throughout the Northeast Florida region, including our six award-winning hospitals: Baptist Medical Center Jacksonville, Wolfson Children’s Hospital, Baptist Medical Center Beaches, Baptist Medical Center Clay, Baptist Medical Center Nassau and Baptist Medical Center South. The most preferred health care system in the region, Baptist Health also includes 57 primary care offices, as well as home health, behavioral health, pastoral care, rehabilitation services, occupational health and urgent care.