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Free Utilization Review Training Jobs in Florida

GLC On-The-Go

Travel Utilization Review RN

Fort Myers, FL · On-site

$2.0K - $2.1K/wk

Pay package is based on 8 hour shifts and 40 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: Registered Nurse - Utilization Review About GLC ...

Acadia Healthcare

Utilization Specialist

Ocklawaha, FL

$20/hr

We are looking to for a Full Time Utilization Review Specialist to join our team. The UR specialist ... Provide ongoing support and training for staff on documentation or charting requirements, continued ...

Acadia Healthcare

Utilization Specialist

Ocklawaha, FL · On-site

$20/hr

We are looking to for a Full Time Utilization Review Specialist to join our team. The UR specialist ... Provide ongoing support and training for staff on documentation or charting requirements, continued ...

Florida Blue

Concurrent Review Nurse

Jacksonville, FL · On-site

$71K - $115K/yr

Utilization Review/Management General Physical Demands * Exerting up to 10 pounds of force ... skills, training, and experience you bring. We are an Equal Employment Opportunity employer ...

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Free Utilization Review Training information

What is free utilization review training?

Free utilization review training refers to educational programs or courses that teach individuals the fundamentals of utilization review without requiring payment. Utilization review is a process used in healthcare to assess the necessity, efficiency, and appropriateness of medical services, procedures, or admissions. These free training options are often available online and can help nurses, case managers, or other healthcare professionals gain the skills needed to pursue roles in utilization management. Training typically covers topics such as clinical guidelines, insurance protocols, and regulatory compliance. Completing such training can enhance career opportunities in healthcare case management and insurance settings.

What are the key skills and qualifications needed to thrive as a utilization review nurse, and why are they important?

To thrive as a Utilization Review Nurse, you need a current RN license, strong clinical assessment skills, and knowledge of insurance and healthcare regulations. Familiarity with utilization management software, electronic health records (EHRs), and possibly certifications like Certified Utilization Review Nurse (CURN) are typically expected. Excellent communication, analytical thinking, and attention to detail are standout soft skills in this position. These abilities are crucial for ensuring appropriate patient care, compliance, and cost-effective healthcare delivery.

What are some common challenges faced by professionals during utilization review training, and how can they be overcome?

During utilization review training, professionals often encounter challenges such as adapting to complex healthcare regulations, learning to interpret medical records efficiently, and effectively applying clinical guidelines to decision-making. Overcoming these challenges requires strong attention to detail, ongoing engagement with training modules, and seeking mentorship from experienced utilization review nurses or case managers. Actively participating in case discussions and staying updated with industry standards can also help trainees build confidence and competence for a successful career in utilization review.

What is the difference between Free Utilization Review Training vs Utilization Review Nurse?

AspectFree Utilization Review TrainingUtilization Review Nurse
CredentialsTypically no formal credentials required; focus on training programsRegistered Nurse (RN) license required, with possible certifications like CCM or UR-specific credentials
Work EnvironmentTraining sessions, online courses, workshopsHospitals, insurance companies, healthcare facilities
Employer & Industry UsageUsed for skill development and certification prepPerforming reviews, making coverage decisions, ensuring appropriate care

Free Utilization Review Training provides foundational knowledge and skills for those interested in entering or advancing in utilization review roles. In contrast, a Utilization Review Nurse is a licensed healthcare professional actively performing review duties in clinical settings. The training is often a prerequisite or supplement to the nurse's practical work, which requires licensure and clinical experience.

How to become a free utilization review training?

To pursue free utilization review training, individuals can seek online courses, webinars, or workshops offered by healthcare organizations or professional associations. Gaining knowledge of medical terminology, insurance processes, and review protocols is essential, and some programs may require prior healthcare experience or certification in related fields.

What are popular job titles related to Free Utilization Review Training jobs in Florida?

For Free Utilization Review Training jobs in Florida, the most frequently searched job titles are:

What job categories do people searching Free Utilization Review Training jobs in Florida look for?

The top searched job categories for Free Utilization Review Training jobs in Florida are:

What cities in Florida are hiring for Free Utilization Review Training jobs?

Cities in Florida with the most Free Utilization Review Training job openings:

Free Utilization Review Training jobs near you
Infographic showing various Free Utilization Review Training job openings in Florida as of June 2026, with employment types broken down into 61% Full Time, 35% Part Time, 2% Temporary, and 2% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution.

Utilization Review Specialist (Tampa)

Clean Recovery Centers

Tampa, FL • On-site

Full-time

Re-posted 4 days ago

Job description

The URS is responsible for creating and managing the flow of revenue for each client at Clean Recovery centers through liaison with insurance companies. The URS establishes a file on all incoming clients with insurance and maintains authorization for reimbursement from pre-certification through continuing stay reviews, through discharge of referral. The URS uses communication, reading and writing skills to establish the most appropriate reimbursement for the level of care being provided. The ideal candidate has skills in gathering information from clinicians, navigating EMRs and creating cases for presentation. Maintains internal tracking documents and spreadsheets daily and/or as instructed.

URS is responsible for ensuring the necessity and appropriateness of care effective benefit management and coordination

  1. Reviewing medical necessities and medical record documentation and communicating health concerns for obtaining information.
  2. Calls insurance companies to obtain precertification or concurrent with the level of care.
  3. Attend team meetings to gain information and provide training to clinicians as to data needs.
  4. Establish positive relationships with insurance providers.
  5. Identify trends in reimbursements and report to supervisor through verbal and generation of graphics.
  6. Promptly work on denials of level of care and obtaining necessary additional medical history to overturn denials.
  7. Following up and communicating treatment plans to insurance payors for ongoing authorization.
  8. Ensuring prompt Communication to management on denials or payor issues.
  9. Work closely with all departments.
  10. Keep accurate records of all transactions and communication with insurances.
  11. Accurately transfer all information to the billing department.
  12. Knowledge of Insurance company portals, payspan, zelis and other portals
  13. Knowledge of Microsoft Word, Outlook and Excel required
  14. Knowledge of Adobe required
  15. Reports to work as assigned and keep workplace professional.
  16. Maintain acceptable overall attendance.
  17. Attends in-service and educational training as necessary and assigned.
  18. Reports personal symptoms of suspected illnesses and contagious diseases to supervisor.
  19. Reports incidents, accidents, and occurrences in accordance with policy and procedure.
  20. Maintains safety of the physical environment.
  21. Independently solves problems and follows through.

Perform other duties and tasks as assigned.

High School Diploma or equivalent

Experience with ASAM and LOCUS criteria  

Ability to interpret ASAM, LOCUS InterQual, 12 step and Treatment Planning for SUD and MH and to apply information to patient authorizations 

Ability to work with a team and have effective communication, organizational and interpersonal skills 

Ability to work under stressful conditions and be flexible in relation to department needs 

Understanding of medical and behavioral health terminology 

Knowledge of state and federal statutes regarding patient confidentiality 

Attention to detail

Experience preferred in behavioral health initial and concurrent review processes 

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