Florida Licensed Medical Review Nurse

Job Summary

A company is looking for a Medical Review Nurse (RN).

Key Responsibilities

• Perform medical reviews to assess appropriate care levels using established criteria
• Build relationships with facility case managers to facilitate discharge planning
• Evaluate members in various healthcare settings for benefit determination and medical necessity

Required Qualifications

• RN license in the state or a compact licensure
• Bachelor's degree in nursing or equivalent work experience
• Recent clinical experience evaluating hospital benefit and medical necessity within the past 3-5 years