Utilization Review RN

Trinity Health

Utilization Review Nurse ensuring appropriate admissions and healthcare cost management at Holy Cross Hospital in Florida. Collaborating with medical staff to verify treatment necessity and authorizations.

Posted 7/8/2026part-timeFort Lauderdale • Florida • 🇺🇸 United StatesMid-LevelSeniorWebsite

About the role

Key responsibilities & impact

Reviews hospital admissions to ensure appropriate admission status in accordance with MCG/InterQual criteria
Monitors on an ongoing basis case assignment for Managed Care Companies authorization of hospital stay
Reviews urgent cases authorized for one day within 24 hours of admission
Reviews concurrent cases and discharge plans in timeframes determined in the review process with external entities
Provides clinical data as part of the telephonic or electronic review process to external parties to ensure continued stay authorizations
Coordinates Physician Advisor referrals with there are concerns regarding meeting level of care criteria
Ensure Observation services begin when care is initiated in accordance with the physician’s order for patients placed in observation

Requirements

What you’ll need

Graduate of an accredited school of professional nursing
Licensed RN in the State of Florida is required
Bachelor of Nursing is preferred. (BSN)

Benefits

Comp & perks

Comprehensive benefits that start on your first day of work
Retirement savings program with employer matching

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

Hospital Admission ReviewConcurrent Case ReviewDischarge PlanningObservation Services CoordinationManaged Care Authorization

Certifications

Bachelor of Nursing (Preferred)