Employer Industry: Healthcare Insurance Provider

Why Consider this Job Opportunity:
- Competitive salary up to $[highest pay]
- Opportunity for career advancement and growth within the organization
- Remote work opportunity with the flexibility to work from home
- Supportive and collaborative work environment
- Chance to make an impact on the health and wellness of Medicare beneficiaries
- Comprehensive benefits package including medical, dental, and vision coverage

What to Expect (Job Responsibilities):
- Utilize clinical nursing skills to support the coordination, documentation, and communication of medical services and benefit administration determinations
- Coordinate and communicate with providers, members, or other parties to facilitate optimal care and treatment
- Interpret criteria, policies, and procedures to provide the best and most appropriate treatment, care, or services for members
- Make decisions regarding work methods and requires minimal direction
- Follow established guidelines and procedures

What is Required (Qualifications):
- Unrestricted Registered Nurse (RN) in the state of Florida with no disciplinary action
- Minimum of 2 years clinical experience in hospital acute care experience with a broad background in ICU, CCU, ER, and Med Surg
- Strong proficiency with MS Office Suite
- Ability to work independently under general instructions and with a team
- Availability to work Saturday-Tuesday 6:30 am- 5:30 pm

How to Stand Out (Preferred Qualifications):
- Utilization management experience
- Health Plan experience
- Previous Medicare/Medicaid Experience
- Call center or triage experience
- Bilingual Spanish/English proficiency
- Interqual or Millman experience

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