Florida Licensed Review Nurse

Job Summary

A company is looking for a Preservice Review Nurse RN to perform clinical coverage review services remotely.

Key Responsibilities

• Perform clinical coverage review services, interpreting mandates and clinical information
• Collaborate with team members to meet performance metrics and communicate benefit determinations
• Engage with healthcare providers and members to discuss coverage decisions and gather clinical information

Required Qualifications

• Current unrestricted RN license in the state of residency
• Professional experience in direct patient care
• Demonstrated proficiency in computer skills, including Microsoft platforms and clinical tools
• Designated secure workspace with high-speed internet access
• Flexible work hours with availability for weekend rotations