ZipRecruiter

Log In

1

Utilization Review Rn Jobs in Tampa, FL (NOW HIRING)

TJM Properties

LPN Charge Nurse/MDS Coordinator

Belleair, FL · On-site

$31 - $39.50/hr

We are seeking a highly skilled and detail-oriented MDS Coordinator (Must have active FL RN or LPN ... Familiarity with ICD-10 coding standards, DRG assignment, and utilization review processes.

Mission Hospital

Case Manager RN PRN

Largo, FL · On-site

You will promote cost effectiveness through the integration of case management, utilization review management and discharge planning. What qualifications you will need: * Current Florida State RN ...

previous page

Showing results 41-60

All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in Tampa, FL

Utilization Review Rn information

See Tampa, FL salary details

$20

$39

$65

How much do utilization review rn jobs pay per hour?

As of Aug 8, 2026, the average hourly pay for utilization review rn in Tampa, FL is $39.96, according to ZipRecruiter salary data. Most workers in this role earn between $31.59 and $45.87 per hour, depending on experience, location, and employer.

How does a utilization review RN collaborate with physicians and other healthcare professionals during the patient care review process?

A Utilization Review RN works closely with physicians, case managers, and other healthcare team members to ensure that patients receive appropriate care while adhering to regulatory and insurance guidelines. This collaboration often involves discussing clinical findings, clarifying documentation, and negotiating care plans to meet both patient needs and payer requirements. Effective communication and teamwork are essential, as Utilization Review RNs frequently serve as liaisons between clinical staff and insurance representatives to facilitate timely authorizations and prevent unnecessary delays in patient care.

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

To thrive as a Utilization Review RN, you need a current RN license, strong clinical assessment skills, and knowledge of healthcare regulations and insurance guidelines. Familiarity with utilization management software, electronic health records (EHRs), and relevant certifications like CCM or ACM is often required. Excellent critical thinking, communication, and negotiation skills help you advocate for appropriate patient care while collaborating with providers and payers. These skills ensure cost-effective, quality care and compliance with regulatory standards in healthcare delivery.

How to get into utilization review as a registered nurse?

To become a utilization review RN, you typically need a valid registered nurse license and experience in clinical settings. Additional certifications such as the Certified Professional in Healthcare Quality (CPHQ) or knowledge of medical coding and insurance processes can enhance your qualifications. Gaining experience in case management or health insurance companies can also improve your chances of entering the field.

What is the difference between Utilization Review Rn vs Case Manager?

AspectUtilization Review RnCase Manager
CredentialsRN license, certifications in utilization reviewRN license, certifications in case management
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, community agencies, insurance companies
Primary FocusReviewing medical necessity and appropriateness of careCoordinating patient care and discharge planning

Utilization Review Rns primarily focus on evaluating the necessity of medical treatments, while Case Managers coordinate patient care and discharge planning. Both roles require RN licensure and certifications, but their daily responsibilities and work environments differ slightly, with Utilization Review Rns concentrating on review processes and Case Managers on patient advocacy and care coordination.

What is a utilization review RN?

A Utilization Review RN is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services and treatments provided to patients. They review medical records, collaborate with healthcare teams, and ensure that patient care meets established guidelines and payer requirements. Their role helps control costs, optimize care, and support compliance with healthcare regulations. Utilization Review RNs often work in hospitals, insurance companies, or managed care organizations.
What are the most commonly searched types of Utilization Review Rn jobs in Tampa, FL? The most popular types of Utilization Review Rn jobs in Tampa, FL are:
What are popular job titles related to Utilization Review Rn jobs in Tampa, FL? For Utilization Review Rn jobs in Tampa, FL, the most frequently searched job titles are:
What job categories do people searching Utilization Review Rn jobs in Tampa, FL look for? The top searched job categories for Utilization Review Rn jobs in Tampa, FL are:
What cities near Tampa, FL are hiring for Utilization Review Rn jobs? Cities near Tampa, FL with the most Utilization Review Rn job openings:
Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Tampa, FL as of August 2026, with employment types broken down into 3% As Needed, 91% Full Time, and 6% Part Time. Highlights an 90% In-person, and 10% Remote job distribution, with an average salary of $83,111 per year, or $40 per hour.

LPN Charge Nurse/MDS Coordinator

TJM Properties

Belleair, FL • On-site

$31 - $39.50/hr

Other

Posted 5 days ago

Job description

We are seeking a highly skilled and detail-oriented MDS Coordinator (Must have active FL RN or LPN Nursing License) to join our healthcare team. The ideal candidate will possess comprehensive knowledge of the Minimum Data Set (MDS)/PDPM process, clinical documentation, and regulatory compliance standards. As an essential member of our interdisciplinary team, the MDS Coordinator will oversee the accurate collection, review, and submission of resident data to ensure optimal reimbursement, quality reporting, and compliance with federal and state regulations. This role offers an opportunity to contribute significantly to patient care quality and operational efficiency within a dynamic healthcare environment.
Responsibilities

  • Coordinate the comprehensive assessment and documentation of resident conditions in accordance with MDS guidelines, ensuring accuracy and completeness.
  • Collaborate with nursing staff, physicians, case managers, and other healthcare professionals to gather pertinent clinical information for MDS completion.
  • Review medical records, clinical documentation, and coding details-including ICD-10 codes-to support precise data entry and compliance with SNF Medicare and other payer requirements.
  • Ensure timely submission of MDS assessments in alignment with regulatory deadlines while maintaining adherence to state-specific regulations.
  • Utilize EMR (Electronic Medical Record) systems such as Point Click Care or similar to document assessments within the electronic health record (EHR)
  • Conduct ongoing education for staff on documentation improvement strategies, utilization management, and coding updates related to ICD coding systems.
  • Monitor quality metrics related to clinical documentation improvement (CDI), discharge planning, hospice care, and case management processes to optimize patient care outcomes.
  • Maintain strict compliance with HIPAA regulations while managing sensitive medical records and ensuring confidentiality throughout all documentation processes.
Qualifications
  • Proven experience in managed care settings or hospital environments with a strong understanding of inpatient and outpatient clinical workflows.
  • Extensive knowledge of Point Click Care, Simple LTC or similar EMR Systems
  • Familiarity with ICD-10 coding standards, DRG assignment, and utilization review processes.
  • Background in medical office administration or health information management with a focus on medical documentation review.
  • Strong understanding of SNF Medicare regulations, discharge planning procedures, and hospice care protocols.
  • Excellent organizational skills coupled with the ability to interpret complex medical terminology and physiology knowledge for accurate data collection.

Apply