Florida Licensed Medical Review Nurse

Job Summary

A company is looking for a Pre/Post Service Medical Review Nurse RN.

Key Responsibilities

• Conduct on-site reviews of subscriber's medical information for benefit administration
• Consult with providers and families to ensure cost-efficient care delivery
• Compile reports to identify cost savings and process improvement opportunities

Required Qualifications

• Bachelor's degree in a nursing-related field
• Unrestricted Florida RN license or Nursing Compact license
• Previous CMS experience and familiarity with organization determinations
• Experience with Jiva, Seibel, and Diamond preferred
• Valid Florida driver's license