Florida Licensed Clinical Review Nurse

To support patient care initiatives, the full-time Florida Licensed Clinical Review Nurse will perform concurrent reviews to assess medical necessity, coordinate discharge planning, and collaborate with healthcare providers while working remotely. Key responsibilities Complete timely inpatient utilization reviews against medical necessity criteria and health plan policies Document clinical findings and collaborate with providers and internal teams to facilitate care and discharge planning Assist with quality reviews, audits, and compliance activities while managing daily case volume effectively Required qualifications Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing 2 - 4 years of related experience, including 2+ years of acute care experience Knowledge of Medicare and Medicaid regulations preferred Understanding of utilization management processes preferred Current Florida nursing license required