Florida Licensed Utilization Management RN

Working remotely, the Florida Licensed Utilization Management RN will perform utilization management and review for in-home long-term care services, ensuring medical necessity and collaborating with the Medical Director while maintaining accurate documentation. Key responsibilities Perform utilization management and concurrent review to determine medical necessity for services Identify solutions for non-standard requests and provide coaching and feedback to less experienced team members Prepare and present cases for Medical Director review, ensuring timely and accurate documentation of decisions Required qualifications Unrestricted RN license in the state of Florida Experience in Managed Care and/or Clinical settings, preferably within Medicaid and Utilization Management Proficiency in Microsoft Office (Word, Excel, PowerPoint) and navigating a Windows environment