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Non Exempt No Experience Utilization Management Nurse Jobs in Florida

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Clinical Reviewer Nurse

Miramar, FL · On-site

Provide updates to Manager of Utilization Management for review What will you come with: * State licensure as a LPN or RN * Minimum 2 years of prior experience in Utilization Management * Strong ...

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Non Exempt No Experience Utilization Management Nurse information

What is the difference between Non Exempt No Experience Utilization Management Nurse vs Utilization Management Nurse?

AspectNon Exempt No Experience Utilization Management NurseUtilization Management Nurse
CredentialsTypically no required certifications, entry-levelOften requires RN license, certifications like CCM or CUC
Work EnvironmentFast-paced, administrative and clinical settingsClinical review, insurance or healthcare facilities
Employer & IndustryHospitals, insurance companies, healthcare providersInsurance companies, managed care organizations

The Non Exempt No Experience Utilization Management Nurse is an entry-level role suitable for those starting in healthcare, often without certifications. In contrast, the Utilization Management Nurse typically requires an RN license and relevant certifications, with more clinical responsibilities. Both roles work within healthcare and insurance settings but differ in experience and qualification requirements.

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What cities in Florida are hiring for Non Exempt No Experience Utilization Management Nurse jobs? Cities in Florida with the most Non Exempt No Experience Utilization Management Nurse job openings:
Non Exempt No Experience Utilization Management Nurse jobs near you
Infographic showing various Non Exempt No Experience Utilization Management Nurse job openings in Florida as of May 2026, with employment types broken down into 2% Locum Tenens, 63% Full Time, 11% Part Time, 20% Contract, and 4% Nights. Highlights an 90% Physical, and 10% Hybrid job distribution.
RN, Utilization Management | Utilization Management

RN, Utilization Management | Utilization Management

UF Health

Saint Augustine, FL • On-site

Full-time

Posted 7 days ago

Job description

Overview
Make an impact by supporting the right care at the right time through utilization management excellence.
Work Style: Onsite
Location: St. Agustine, FL
FTE: Full-Time (1.0 FTE)
⏰ Schedule: Monday - Friday, 3:00 PM - 11:00 PM
Plays a critical role in evaluating patient medical records to ensure the necessity and appropriateness of healthcare services. Involves coordinating with healthcare providers to maintain compliance with utilization management guidelines and optimizing treatment plans for effective patient care and resource utilization. Requires clear communication of authorization decisions and ongoing monitoring to support timely discharge planning. Analyzes utilization data to identify trends and collaborates with interdisciplinary teams to enhance care coordination while ensuring accurate documentation and regulatory compliance.
Responsibilities
Key Responsibilities
  • Evaluates patient medical records to determine the medical necessity and appropriateness of healthcare services.
  • Coordinates with healthcare providers and care teams to ensure compliance with utilization management guidelines and payer requirements.
  • Supports effective treatment planning, patient care coordination, and appropriate resource utilization.
  • Communicates authorization decisions and utilization determinations while supporting timely discharge planning efforts.
  • Analyzes utilization management data and trends to identify opportunities for improved care coordination and operational efficiency.
  • Collaborates with interdisciplinary teams to ensure accurate documentation, regulatory compliance, and quality patient outcomes.

Qualifications
Education & Licensure
  • Registered Nurse (RN) with a current Florida nursing license required.

Experience & Skills
  • Minimum of three (3) years of experience in utilization review, utilization management, or case management required.
  • Knowledge of healthcare utilization guidelines, payer requirements, and regulatory compliance standards.
  • Experience evaluating medical necessity, treatment plans, and appropriate levels of care.
  • Strong communication and collaboration skills related to authorization determinations and care coordination.
  • Demonstrated ability to analyze utilization data, identify trends, and support patient care and discharge planning initiatives.

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