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Anthem Utilization Review Jobs in Florida (NOW HIRING)

Trivium

Senior Executive Assistant

Miami, FL · On-site

$70K - $90K/yr

Operational Filter: Track requests from internal teams, ensure Mina reviews key items, and ... High AI utilization especially Claude. Expert in GSuite, Slack, CRM platforms, Project management ...

New

Trivium

Senior Executive Assistant

Miami Gardens, FL · On-site

$70K - $90K/yr

Operational Filter: Track requests from internal teams, ensure Mina reviews key items, and ... High AI utilization especially Claude. Expert in GSuite, Slack, CRM platforms, Project management ...

Trivium

Senior Executive Assistant

Miami, FL · On-site

$70K - $90K/yr

Operational Filter: Track requests from internal teams, ensure Mina reviews key items, and ... High AI utilization especially Claude. Expert in GSuite, Slack, CRM platforms, Project management ...

Trivium

Senior Executive Assistant

Miami Beach, FL · On-site

$70K - $90K/yr

Operational Filter: Track requests from internal teams, ensure Mina reviews key items, and ... High AI utilization especially Claude. Expert in GSuite, Slack, CRM platforms, Project management ...

New

Trivium

Senior Executive Assistant

Miami, FL · On-site

$70K - $90K/yr

Operational Filter: Track requests from internal teams, ensure Mina reviews key items, and ... High AI utilization especially Claude. Expert in GSuite, Slack, CRM platforms, Project management ...

Trivium

Senior Executive Assistant

Miami Gardens, FL · On-site

$70K - $90K/yr

Operational Filter: Track requests from internal teams, ensure Mina reviews key items, and ... High AI utilization especially Claude. Expert in GSuite, Slack, CRM platforms, Project management ...

New

Trivium

Senior Executive Assistant

Miami Beach, FL · On-site

$70K - $90K/yr

Operational Filter: Track requests from internal teams, ensure Mina reviews key items, and ... High AI utilization especially Claude. Expert in GSuite, Slack, CRM platforms, Project management ...

All JobsAnthem Utilization Review JobsAnthem Utilization Review Jobs in Florida

Anthem Utilization Review information

See Florida salary details

$15

$31

$51

How much do anthem utilization review jobs pay per hour?

As of Sep 5, 2026, the average hourly pay for anthem utilization review in Florida is $31.60, according to ZipRecruiter salary data. Most workers in this role earn between $24.95 and $36.30 per hour, depending on experience, location, and employer.

What is an Anthem Utilization Review?

An Anthem Utilization Review job involves assessing medical services and treatments to ensure they are necessary, cost-effective, and aligned with insurance policies. Professionals in this role review patient records, apply clinical guidelines, and collaborate with healthcare providers to determine coverage eligibility. They help prevent unnecessary procedures while supporting quality patient care. This position typically requires a healthcare background, such as nursing or case management, along with knowledge of insurance regulations and medical necessity criteria.

What does an Anthem Utilization Review do?

A typical day in an Anthem Utilization Review position involves evaluating medical records and authorization requests to determine if healthcare services meet established criteria for coverage. You’ll collaborate frequently with healthcare providers, case managers, and internal teams to clarify clinical information and help guide appropriate care pathways. The job is largely desk-based and requires strong organizational skills to manage multiple concurrent cases and meet tight deadlines. Most professionals in this role work within a team structure, sharing best practices and supporting each other in making objective, evidence-based decisions. This dynamic environment offers exposure to a variety of healthcare scenarios and opportunities for ongoing learning in utilization management.

What are the key skills and qualifications needed to thrive in an Anthem Utilization Review?

To thrive as an Anthem Utilization Review professional, you need a background in nursing or healthcare, strong analytical abilities, and familiarity with medical terminology and insurance guidelines. Experience with clinical documentation systems, review software, and URAC or NCQA certifications are commonly required. Excellent communication, critical thinking, and attention to detail are crucial soft skills in this position. These capabilities ensure accurate review of medical necessity, effective collaboration with providers, and regulatory compliance, which are vital for quality patient outcomes and cost management.

What are the most commonly searched types of Anthem Utilization Review jobs in Florida?

The most popular types of Anthem Utilization Review jobs in Florida are:

What are popular job titles related to Anthem Utilization Review jobs in Florida?

For Anthem Utilization Review jobs in Florida, the most frequently searched job titles are:

What job categories do people searching Anthem Utilization Review jobs in Florida look for?

The top searched job categories for Anthem Utilization Review jobs in Florida are:

Anthem Utilization Review jobs near you
Infographic showing various Anthem Utilization Review job openings in Florida as of August 2026, with employment types broken down into 86% Full Time, and 14% Part Time. Highlights an 93% In-person, and 7% Hybrid job distribution, with an average salary of $65,722 per year, or $31.6 per hour.

MDS Coordinator RN

Heritage Park Health Center by Harborview

Bradenton, FL

$33.75 - $40.75/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 22 days ago

Job description

MDS Coordinator - RN

Top pay and benefits!

Who we are

As a faith-based organization, our mission is simple but powerful: to care for the caregiver so they can in turn care for our residents.

We offer top pay and benefits in a positive work environment.

The Opportunity

We are currently seeking an experienced MDS Coordinator to lead the clinical assessment and reimbursement process. In this essential role, you will manage all aspects of the Minimum Data Set (MDS) assessment process to ensure accurate documentation, optimal reimbursement, and compliance with regulatory requirements. You will collaborate closely with interdisciplinary team members to develop person-centered care plans and advocate for resident needs.

What You Will Do

  • Complete and submit timely and accurate MDS assessments

  • Select appropriate ARDs and diagnosis codes to ensure accurate PDPM classification and reimbursement

  • Monitor PDPM components, validate supporting documentation, and ensure compliance with CMS requirements

  • Coordinate and lead care planning across Nursing, Therapy, Social Services, Dietary, and Activities departments

  • Conduct and participate in IDT meetings including: daily PDPM, weekly CMI, Utilization Review, monthly Triple Check, and care plan conferences

  • Utilize programs such as PCC, SimpleLTC, NetHealth, Teams, IQIES, Myers & Stauffer, Power DMS, and Google Sheets

  • Other duties as assigned

What You Must Have

  • Active RN license in good standing in the state of practice

  • Experience in skilled nursing and long term care

  • Experience using MDS tracking and assessment tools such as SimpleLTC and PCC is a plus

Benefits - Things we want you to know

  • We offer a comprehensive benefits package, including:

    • 401(k) managed by Merrill Lynch

    • DailyPay

    • Health Insurance with Anthem Blue Cross or Cigna

    • Dental, Life, Vision, and Disability Insurance

    • Paid Time Off