ZipRecruiter

Log In

1

Weekend Supervisor Utilization Management Jobs in Florida

UHS

DIR - UTILIZATION REVIEW / MGMT

Oakland Park, FL · On-site

The Director supervises all Utilization Management activities, including conducting audits to assure medical necessity criteria is met and is clearly documented in the medical record, immediately ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Oakland Park, FL · On-site

The Director supervises all Utilization Management activities, including conducting audits to assure medical necessity criteria is met and is clearly documented in the medical record, immediately ...

West Orange Center

Weekend Supervisor

Ocoee, FL · On-site

) Weekend Supervisor - Vivo West Orange (Ocoee, FL) Position Summary Vivo West Orange is seeking a reliable and experienced Weekend Supervisor (LPN or RN) to oversee clinical operations and ensure high ...

next page

Showing results 1-20

All JobsSupervisor Utilization Management JobsWeekend Supervisor Utilization Management JobsWeekend Supervisor Utilization Management Jobs in Florida

Weekend Supervisor Utilization Management information

What are the primary challenges a Weekend Supervisor in Utilization Management faces, and how can they be addressed?

Weekend Supervisors in Utilization Management often encounter challenges such as limited staff availability, high patient volume, and the need for rapid decision-making with less direct access to physicians or ancillary services. To address these, strong organizational skills, proactive communication, and the ability to prioritize urgent cases are essential. Supervisors should foster a collaborative atmosphere, leverage digital tools for efficient workflow, and ensure clear escalation protocols for complex cases, all while maintaining regulatory compliance and quality patient care.

What are the key skills and qualifications needed to thrive as a Weekend Supervisor Utilization Management, and why are they important?

To thrive as a Weekend Supervisor Utilization Management, you need a comprehensive understanding of clinical guidelines, utilization review processes, and healthcare regulations, typically supported by a nursing degree (RN) or related clinical licensure. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of relevant accreditation standards (such as URAC or NCQA) are essential. Strong leadership, decision-making, and effective communication skills help navigate team dynamics and complex case reviews during weekend shifts. These skills ensure efficient resource management, compliance with healthcare standards, and consistent quality of care even outside regular business hours.

What is the difference between Weekend Supervisor Utilization Management vs Weekend Utilization Review Coordinator?

AspectWeekend Supervisor Utilization ManagementWeekend Utilization Review Coordinator
CredentialsTypically requires a healthcare-related license or certification (e.g., RN, LPN, or case management certification)Often requires similar healthcare credentials, such as RN or case management certification
Work EnvironmentSupervises utilization management staff, oversees case reviews, and ensures compliance during weekendsPerforms case reviews, evaluates medical necessity, and coordinates utilization decisions during weekends
Employer & IndustryHospitals, insurance companies, healthcare organizationsHospitals, insurance providers, healthcare organizations

The main difference is that the Weekend Supervisor Utilization Management role involves supervising staff and managing utilization processes, while the Weekend Utilization Review Coordinator focuses on conducting case reviews and making utilization decisions during weekends. Both roles require healthcare credentials and operate within similar environments, but their responsibilities differ in scope and leadership level.

What does a Weekend Supervisor in Utilization Management do?

A Weekend Supervisor in Utilization Management oversees the review and coordination of patient care services during weekends to ensure appropriate use of healthcare resources. They manage a team of utilization review staff, ensure compliance with policies, and facilitate communication between healthcare providers and insurance companies. Their role is critical in making timely decisions about patient admissions, continued stays, and discharges, focusing on quality care and cost efficiency. They also handle escalations and provide support to staff working outside of regular business hours.
What are the most commonly searched types of Supervisor Utilization Management jobs in Florida? The most popular types of Supervisor Utilization Management jobs in Florida are:
What are popular job titles related to Weekend Supervisor Utilization Management jobs in Florida? For Weekend Supervisor Utilization Management jobs in Florida, the most frequently searched job titles are:
What job categories do people searching Weekend Supervisor Utilization Management jobs in Florida look for? The top searched job categories for Weekend Supervisor Utilization Management jobs in Florida are:
What cities in Florida are hiring for Weekend Supervisor Utilization Management jobs? Cities in Florida with the most Weekend Supervisor Utilization Management job openings:
Weekend Supervisor Utilization Management jobs near you
RN, Utilization Management | Utilization Management

RN, Utilization Management | Utilization Management

UF Health

The Villages, FL • On-site

Full-time

Re-posted 20 days ago

Job description

Overview

Join an onsite clinical team focused on ensuring the right care at the right time for every patient.

???? Work Style: Onsite
???? Location: The Villages, FL
???? FTE: Full-Time (1.0 FTE)
????️ Schedule: Monday – Friday (occasional weekends required)

Evaluates patient medical records to determine the medical necessity and appropriateness of healthcare services in alignment with utilization management guidelines. Collaborates with healthcare providers to support compliance, optimize treatment plans, and promote efficient resource utilization.

Communicates authorization decisions clearly and monitors patient progress to support timely discharge planning. Analyzes utilization data to identify trends and opportunities for process improvement.

Partners with interdisciplinary teams to enhance care coordination, ensure accurate documentation, and maintain compliance with regulatory and organizational standards.


Responsibilities

Key Responsibilities

  • Evaluates patient medical records to ensure the necessity and appropriateness of healthcare services.
  • Coordinates with healthcare providers to ensure compliance with utilization management guidelines.
  • Supports the optimization of treatment plans to promote effective patient care and appropriate resource utilization.
  • Communicates authorization decisions clearly and supports timely discharge planning.
  • Analyzes utilization data to identify trends and opportunities to improve care coordination.
  • Collaborates with interdisciplinary teams to ensure accurate documentation and regulatory compliance.

Qualifications

Education & Experience:


Registered Nurse (RN) with a current Florida license required.

  • Three (3) years of critical care nursing experience, or
  • Five (5) years of medical-surgical nursing experience, or
  • Three (3) years of utilization review, case management, or third-party payer experience.

Qualifications

  • Active Registered Nurse (RN) license with 3+ years of experience in utilization review or case management.
  • Strong knowledge of healthcare utilization management guidelines and regulatory compliance.
  • Experience evaluating medical necessity and optimizing treatment plans.
  • Excellent communication skills with the ability to clearly convey authorization decisions.
  • Ability to analyze utilization data and support effective care coordination.
  • Strong organizational skills with the ability to manage multiple priorities simultaneously.
  • Ability to work independently and collaboratively with multidisciplinary teams.
  • Strong attention to detail and innovative problem-solving skills.
  • Flexibility to adjust work hours and days based on departmental needs.

Motor Vehicle Operator Designation:
Employees in this position will not operate vehicles for an assigned business purpose.

Note: Please indicate the appropriate operator designation on the Request for Personnel (RFP) form at the time of submission.

Licensure/Certification/Registration:

  • Registered Nurse (RN) with a current Florida license required.

Apply