Utilization Review Nurse, PRN/Weekend Shift

🔥 29 minutes ago

🐊 Florida – Remote

🐊 Florida – Remote

💵 $45 / hour

⏱ Part Time

🟠 Senior

🔴 Lead

👻 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

• 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 • Ability to work independently with 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 (2) of six organization-recognized holidays each calendar year • Must submit availability thirty (30) days in advance • Must follow attendance and call-off policies • Ability to perform tasks involving physical activity that may include lifting up to 25 pounds • Certified Case Manager (CCM), Accredited Case Manager (ACM), Certified Managed Care Nurse (CMCN), or Case Management Board Certification (CMGT-BC) preferred • Bachelor of Science in Nursing (BSN) preferred

🏖️ Benefits

• PRN scheduling with additional hours based on departmental needs and employee availability • Flexible shift options of four or eight hours, based on departmental needs and manager approval • Opportunity to work remotely • Paid work on recognized holidays is implied by required holiday shifts

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