Utilization Management Nurse
On-site · Miami, Florida, United States
Miami, Florida, United StatesOn-siteFull TimeMid LevelNot SpecifiedUnknown
Type
Full Time
Level
Mid Level
Education
Not Specified
Company size
Unknown
Job Summary
Utilization Management Nurse (LPN or RN) on-site in Miami, FL to conduct concurrent and retrospective utilization review, pre-certify services, and coordinate care for Solis Health Plans members. Requires Florida RN licensure and nursing degree; on-site Monday-Friday; bilingual English/Spanish; 3–5 years RN clinical experience; 2 years UM experience preferred and discharge planning preferred.
Required Qualifications
- Graduate from an accredited school of nursing, or Bachelors (or advanced) degree in nursing
- Active and unrestricted licensure as a Registered Nurse in Florida
- A minimum of three to five years clinical experience as a Registered Nurse in a clinical setting
Desired Qualifications
- 2 years’ experience as a Utilization Management nurse in a managed care payer (preferred)
- One year experience as a case manager in a payer or facility setting (highly preferred)
- Discharge planning experience (highly preferred)
Additional Requirements
- Bilingual in English and Spanish is required
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