Florida Licensed Preservice Review Nurse

A company is looking for a Preservice Review Nurse RN - Remote.

Key Responsibilities

Perform clinical coverage review services, interpreting state and federal mandates and clinical information

Collaborate with a self-directed team to meet performance metrics and communicate benefit determinations

Engage in telephonic discussions with healthcare providers and members regarding coverage determinations

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 systems

Proven clinical documentation and critical thinking skills

Designated secure workspace with high-speed internet access