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15 Medical Review Nurse Jobs in Fort Lauderdale, FL

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Actalent
Fort Lauderdale, FL | Full Time
$159k-195k (estimate)
5 Days Ago
University of Miami
Fort Lauderdale, FL | Full Time
$82k-99k (estimate)
6 Days Ago
The University of Miami
Fort Lauderdale, FL | Full Time
$94k-109k (estimate)
4 Days Ago
The Cleveland Clinic
Fort Lauderdale, FL | Full Time
$95k-120k (estimate)
1 Week Ago
CodeMax Medical Billing
Fort Lauderdale, FL | Full Time
$56k-81k (estimate)
1 Month Ago
Broward Health
Fort Lauderdale, FL | Full Time
$91k-112k (estimate)
7 Months Ago
Broward Health
Fort Lauderdale, FL | Full Time
$81k-101k (estimate)
1 Week Ago
Cleveland Clinic
Fort Lauderdale, FL | Full Time
$91k-115k (estimate)
3 Weeks Ago
AdventHealth Altamonte Springs
Fort Lauderdale, FL | Full Time
$68k-85k (estimate)
4 Months Ago
Broward Health
Fort Lauderdale, FL | Full Time
$81k-101k (estimate)
5 Days Ago
Broward Health
Fort Lauderdale, FL | Full Time
$81k-101k (estimate)
1 Week Ago
Broward Health
Fort Lauderdale, FL | Full Time
$81k-101k (estimate)
1 Week Ago
Medical Review Nurse
Actalent Fort Lauderdale, FL
$159k-195k (estimate)
Full Time 5 Days Ago
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Actalent is Hiring a Medical Review Nurse Near Fort Lauderdale, FL

Job Title: Medical Review NurseJob DescriptionJoin our team as a Utilization Management Specialist, where you will play a pivotal role in reviewing service authorization requests to ensure the utilization of appropriate medical services. Your daily tasks will include reviewing various specialties, medical treatments, home care, and out-of-plan referrals. You will assist with complex cases and contribute to the development of internal processes. Additionally, you will provide education to physicians and team members on utilization review (UR) and appropriate admissions and placements. Managing continuity of care, ensuring safe transitions, patient and provider satisfaction, and appropriate length of stay will also be part of your responsibilities.
Hard Skills
  • Knowledge of case management and UR concepts
  • Utilization review of prior authorizations for medical necessity
  • Familiarity with and ability to apply Milliman and InterQual criteria
Soft Skills
  • Team collaboration
  • Effective communication
  • Process development
Work Site
This is a fully remote position.
Work Environment
This position operates in a fast-paced environment under the supervision of the Medical Director and/or Medical Management supervisor, as part of an interdisciplinary team.
About ActalentActalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.
Diversity, Equity & Inclusion
At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:
  • Hiring diverse talent
  • Maintaining an inclusive environment through persistent self-reflection
  • Building a culture of care, engagement, and recognition with clear outcomes
  • Ensuring growth opportunities for our people
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.

Job Summary

JOB TYPE

Full Time

SALARY

$159k-195k (estimate)

POST DATE

06/21/2024

EXPIRATION DATE

06/22/2024

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The job skills required for Medical Review Nurse include Collaboration, Effective Communication, Case Management, Initiative, etc. Having related job skills and expertise will give you an advantage when applying to be a Medical Review Nurse. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Medical Review Nurse. Select any job title you are interested in and start to search job requirements.

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The following is the career advancement route for Medical Review Nurse positions, which can be used as a reference in future career path planning. As a Medical Review Nurse, it can be promoted into senior positions as a Staff Nurse - RN, Sr. - Medical Management that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Medical Review Nurse. You can explore the career advancement for a Medical Review Nurse below and select your interested title to get hiring information.

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