Florida Licensed Concurrent Review Nurse

Job Summary

Responsible for performing medical reviews to ensure appropriate care levels, the full-time Florida Licensed Concurrent Review Nurse will collaborate with facility case managers and evaluate members in various healthcare settings, all while working remotely.

Key responsibilities

• Serve as a point of contact for providers, assisting in member navigation through the continuum of care and educating them on benefits
• Evaluate members for benefit determination and medical necessity using established criteria in settings such as hospitals and skilled nursing facilities
• Collaborate with Medical Directors and other departments to coordinate care and discharge planning for members

Required qualifications

• 2+ years of clinical experience in a hospital, LTAC, rehab, or SNF setting
• Related Bachelor's degree or equivalent work experience in Nursing
• Current Florida RN license or Compact State Licensure
• Experience in utilization review, discharge planning, or case management
• Proficiency in MS Word and Excel with moderate to heavy keying required