Utilization Review Nurse – Full-Time, Evening Shift

🔥 35 minutes ago

🐊 Florida – Remote

🐊 Florida – Remote

💵 $41 - $43 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 0%

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Brundage Group

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2007

🏥 Healthcare

🤝 B2B

☁️ SaaS

Healthcare • B2B • SaaS

Brundage Group is a physician-led advisory and revenue cycle management firm that helps hospital systems capture earned revenue compliantly and improve clinical documentation, utilization management, DRG integrity, and denials management. The company provides clinical revenue cycle services (physician advisors, utilization review, nurse reviews) and analytics-backed solutions through proprietary products and dashboards (Certus Beacon, Certus Connect, Certus Navigator, Certus Radar) to monitor compliance, quality, and financial performance in real time. Brundage Group primarily serves hospitals and health systems and emphasizes clinician-led guidance combined with tech-enabled analytics to drive ROI and reduce revenue leakage.

📋 Description

• Conduct hospital admission reviews to determine medical necessity and appropriate patient status • Conduct continued stay reviews using approved clinical criteria and guidelines • Evaluate clinical documentation for accuracy, completeness, and compliance with payer and regulatory requirements • Apply evidence-based criteria such as InterQual® and/or MCG® • Communicate review findings and recommendations to physicians, case management staff, and leadership • Collaborate with Physician Advisors regarding complex cases or cases not supported by criteria • Assist with denial prevention activities and accurate documentation • Perform other duties as assigned • Work collaboratively with physicians, case managers, revenue cycle staff, and interdisciplinary care teams to facilitate appropriate patient status determinations and optimize reimbursement while supporting quality patient care

🎯 Requirements

• Extensive acute care nursing experience and demonstrated expertise in utilization review within a hospital setting • Proficient in multiple Electronic Health Records and case management systems • Strong communication skills; communicates clearly and concisely, verbally and in writing • Ability to thrive in a fast-paced environment and adapt to frequently changing business needs • Graduate of an accredited school of nursing • Bachelor’s of Science in Nursing (BSN): preferred • Current, unrestricted Registered Nurse (RN) license • Minimum five (5) years of acute care nursing experience in a hospital setting • Minimum two (2) years of recent hospital-based utilization review experience • Experience with acute admission reviews and continued stay reviews • Certified Case Manager (CCM), Accredited Case Manager (ACM), Certified Managed Care Nurse (CMCN), or Case Management Board Certification (CMGT-BC): preferred • Ability to work 8-, 10-, or 12-hour shifts • Expected to work every other weekend as required • Must work three of six company-recognized holidays annually based on departmental and business needs • Ability to perform tasks involving physical activity that may include lifting up to 25 pounds • Ability to tolerate healthcare and office environmental hazards

🏖️ Benefits

• Full-time employment • 8-, 10-, or 12-hour shifts based on operational needs and mutual scheduling agreements • Work schedules published one month in advance • Three of the six company-recognized holidays assigned annually • Vacation, time off, and schedule accommodation requests accepted with advance notice

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