RN Case Manager, Utilization Review, PRN

Northwest Florida Community Hospital Chipley, FL 32428, US

PRN RN CASE MANAGER – UTILIZATION REVIEW

Northwest Florida Community Hospital (NFCH)
Department: Med-Surg / Utilization Review
Position Type: PRN (As Needed)
Location: Chipley, Florida

Position Summary

Northwest Florida Community Hospital (NFCH) is seeking a qualified and motivated PRN Registered Nurse (RN) Case Manager to support our Med-Surg department. This position is responsible for reviewing patient admissions and continued stays, coordinating patient care, and ensuring appropriate utilization of hospital resources while supporting quality outcomes and compliance with applicable healthcare regulations.

Essential Duties and Responsibilities

Conduct utilization reviews to assess medical necessity, level of care, and appropriateness of hospital admissions and continued stays.
Review medical records and clinical documentation to ensure compliance with payer requirements and established guidelines.
Collaborate with physicians, nursing staff, case management, and other healthcare professionals to support effective patient care.
Identify potential discharge planning needs and assist with coordination of appropriate post-acute services.
Communicate with insurance companies and third-party payers regarding authorization, medical necessity, and continued stay reviews.
Identify opportunities to improve resource utilization, patient outcomes, and length of stay.
Maintain accurate and timely documentation of utilization review activities.
Support compliance with hospital policies, regulatory standards, and applicable reimbursement guidelines.

Qualifications

Current, active Registered Nurse (RN) license in the State of Florida or a multistate license valid for practice in Florida.
Previous acute care nursing experience required.
Experience in utilization review, case management, discharge planning, or medical necessity review preferred.
Knowledge of clinical documentation, insurance authorization processes, and payer requirements preferred.
Strong critical-thinking, communication, organizational, and documentation skills.
Ability to work collaboratively with physicians, nursing staff, and interdisciplinary teams.

Why Join NFCH?

At Northwest Florida Community Hospital, we are committed to providing quality healthcare to our community. Join a team where your clinical expertise can make a meaningful difference in patient care, care coordination, and responsible utilization of hospital resources.

Northwest Florida Community Hospital is committed to the principle of equal employment opportunity for all employees and to providing employees with a work environment free of discrimination and harassment. All employment decisions at Northwest Florida Community Hospital are based on business needs, job requirements and individual qualifications, without regard to race, color, religion or belief, national, social or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate. Northwest Florida Community Hospital will not tolerate discrimination or harassment based on any of these characteristics. We encourage applicants of all ages.

In addition, as part of our commitment to quality and excellence, Northwest Florida Community Hospital will continue to maintain a safe, healthy environment for you by requiring all applicants, who are tentatively selected for a position, to submit to a criminal history check and screening for illegal drug use prior to appointment for a job.

Final confirmation of any job offer will be contingent upon the successful completion of all pre-employment requirements, including a pre-employment drug screening and background screening. Failure to submit to either screening, falsification of any screening information, or a positive finding on a drug test will result in removal from consideration for employment for a period of one year.

https://info.flclearinghouse.com

Share this job

Related Jobs

RN Supervisor

Cedar Manor Ossining, NY

$60 - $62 / hour

Cedar Manor Nursing & Rehabilitation Center is searching for Per Diem RN Supervisors for Days, Evenings, Nights and weekends to become a part of our facility's compassionate care-giving team. We have Weekly Pay! Up to $62/hr depending on experience. Cedar Manor Nursing & Rehabilitation Center is a Skilled Facility located in Westchester County NY, with beautiful panoramic views of the Hudson River. Our facility maintains an environment in which each employee understands their important role, contributing to the facility's consistently top-rated reputation in the surrounding community. Join us and make a difference every day.

RN Supervisor PRN

Rosemont Care & Rehabilitation Center Bryn Mawr, PA

WE ARE SEEKING a PRN Night RN Supervisor Rosemont Center is now hiring an RN Supervisor who is committed to providing the best life and care for our residents. RESPONSIBILITIES OF AN RN SUPERVISOR: Administrating treatments and documentation Complete assessments to determine the resident’s needs. Use health assessment data to determine nursing diagnosis. Counsel patient’s family in meeting nursing related needs. All other duties as assigned by the Director of Nursing. QUALIFICATIONS OF AN RN SUPERVISOR: Must have an active Certification as an RN in the state of PA Minimum two years of experience is required As a Rosemont Center employee, you will receive benefits including PTO, Health Insurance, Dental and Vision Insurance. #MP

Healthcare

Per Diem

2 days ago

Rn prn

WeCare at Rolling Meadows Waynesburg, PA

Registered Nurse (RN) Come join our team and make a difference! WeCare at Rolling Meadows Care Center Located at 107 Curry Road, Waynesburg, PA, 15370 is actively seeking dedicated RN's to add to our growing team! Provide top-quality patient care, oversee medical treatments, and support our healthcare team in delivering excellence. At WeCare we value teamwork and promote a healthy work – life balance . If you strive to deliver top quality care , positivity and compassion come join us! Job Duties Serve as a professional role model by providing leadership, support and guidance. Maintaining nursing staff job performance through multiple intervention practices in close collaboration with Director of Nursing (DON), Human Resources or Facility Administrator, as needed. Ensure FBH policies are being followed. Ensuring nursing staff are providing a safe, healthy environment and utilizing proper techniques and approaches. Ensuring proper documentation is being completed by nursing staff. Effectively communicating with Residents, families, vendors and interdisciplinary team to provide a high quality of care. Participating in compliance and quality improvement committees, audits and processes. Completing nursing staff evaluations, coaching, education, and supervision. Ensures continued delivery of high quality nursing care by monitoring direct care and conducting audits. Assume on-call duties with other Nursing Leadership Staff. Additional duties as assigned by the Director of Nursing. Qualifications Valid RN license in the State of PA Previous experience as a RN in acute care / long term care setting is preferred Benefits Same Day Pay Employee Referral Bonus Program Continuing Education Tuition Program PTO Exchange Program Health Insurance Dental Insurance Vision Insurance Voluntary Benefits 401k with discretionary match EAP About WeCare Centers At WeCare Centers, we believe in not only providing exceptional care for our residents but also ensuring a supportive and enriching environment for our team. Our Voluntary Benefits Programs are designed to provide additional supportive services to our employees that can help them achieve their personal, financial, and health goals. Equal Opportunity Employer Statement WeCare HCC is an equal opportunity employer. We maintain a steadfast commitment to diversity and inclusion in the workplace, ensuring that every employee has the opportunity to thrive and contribute to our mission of compassionate care and community service.

Healthcare

Per Diem

3 days ago

RN Every Other Weekend 7am-3pm or 11pm-7am

Luther Woods Nursing and Rehabilitation Center Hatboro, PA

$40 - $41 / hour

Luther Wood Nursing & Rehabilitation Center in Hatboro, PA is seeking a qualified candidate to join our team as a Registered Nurse (RN). As a Registered Nurse, you are at the forefront of our ability to provide Care Beyond Compare with the exceptional hands-on care you deliver. As a member of the nursing team, you will collaborate with other healthcare professionals to ensure that we are delivering the highest quality of care to our residents; helping them regain and maintain their optimal level of independence through the compassionate care and support you provide. One of the most rewarding aspects of your role is knowing that you will have the opportunity to make a sincere difference in someone’s life every day. What We Offer Competitive rates ranging from $37.00 to $40.00 per hour commensurate with experience Excellent Health Benefits (Medical, Dental, Vision) 401(k), Flexible Spending Account, & Other Elective Benefits Available Paid Time Off (PTO) for Full-Time Employees Career Growth Opportunities Daily Pay Available What You'll Do Supervise, coordinate, and direct the work of nursing assistants (CNAs). Provide individualized nursing care to residents according to each resident’s plan of care. Assist in the admission, transfer, and discharge of patients. Administers prescribed medications and treatments as ordered by the physician. Explains procedures and treatments ordered to gain patients’ cooperation and allay apprehension. Observe vital signs to detect deviations from normal and gage progress of the patient. Maintains patients’ medical record on nursing observation and action taken, such as medications and treatments given, reactions, tests, intake, emission of liquids and solids, and vital signs. Records nursing needs of patient on care plan to assure continuity of care. Observes emotional stability of patients, expresses interest in their progress, and prepares them for continuing care after discharge. Perform other duties as required to provide exceptional care to each resident. What You Need Active unencumbered licensure as a Registered Nurse (RN) in Pennsylvania. Excellent communication and interpersonal skills. Highly organized and detail oriented. Ability to work independently or as part of a team. If you're looking to join an outstanding team of professionals where every day you can make a sincere difference in someone's life, we're looking for you!

Healthcare

Per Diem

5 days ago

RN (Per Diem)

Langdon Place of Dover Dover, NH

$43 - $51 / hour

Langdon Place of Dover is seeking compassionate and skilled Registered Nurses to join our nursing team. If you're looking for an opportunity to build meaningful relationships with residents, utilize your clinical expertise, and work alongside a supportive interdisciplinary team, we'd love to speak with you. Compensation: Competitive pay based on experience Shifts Available: Per Diem team members do not have a set schedule and may pick up as needed based on open shifts, operational need, and per diem requirements. Apply to learn more! Position Summary As a Registered Nurse, you will provide direct nursing care to residents while supervising and supporting LPNs, LNAs, Medication Technicians, and other assigned staff. You will play a key role in resident assessments, care planning, medication administration, clinical decision-making, and ensuring the highest standards of quality care. What You'll Do Assess resident conditions and respond to changes in clinical status. Administer medications and treatments. Perform wound care and monitor treatment progress. Lead and support nursing staff during daily operations. Collaborate with physicians, families, and the interdisciplinary care team. Participate in admissions, transfers, discharges, and care planning. Promote resident dignity, safety, and quality of life. Qualifications Current New Hampshire RN license in good standing. Graduate of an accredited nursing program. CPR certification required. Long-term care experience preferred. Strong clinical, leadership, and communication skills. Langdon Place of Dover is an equal opportunity employer.