Utilization Review Nurse, PRN – Evening Shift

🔥 0 minutes ago

🐊 Florida – Remote

🐊 Florida – Remote

💵 $45 / hour

⏱ Part 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 (inpatient, observation, outpatient) • 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

🎯 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 frequent changing business needs • Ability to work independently, needing minimal supervision • Graduate of an accredited school of nursing • 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 or health plan utilization review experience • Experience with acute admission reviews and continued stay reviews • PRN position requiring a minimum of forty (40) hours per month when hours are available • At least sixteen (16) required monthly hours must be worked on weekend shifts • Must work two of the six organization-recognized holidays each calendar year • Must maintain flexibility and communicate availability according to department scheduling practices • Must report to work as scheduled and follow attendance and call-off policies

🏖️ Benefits

• PRN scheduling with shift options of four or eight hours • Additional hours may be scheduled based on departmental needs and employee availability

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