ZipRecruiter

Log In

2

Entry Level Rn Utilization Review Nurse Jobs in Miami, FL

Sanitas

Case Management RN (68014)

Doral, FL · On-site

... RN manages the transition of care for members post-discharge and those with chronic conditions ... coordination, utilization review, or population health management within a healthcare setting.

Sanitas

Case Management RN (68014)

Doral, FL · On-site

... RN manages the transition of care for members post-discharge and those with chronic conditions ... coordination, utilization review, or population health management within a healthcare setting.

Fabergent

Clinical Care Reviewer

Doral, FL

Current FL RN licensure Registered Nurse graduated from an accredited Diploma, Associates Degree or ... ER, ICU) Experience with Utilization Review and/or Prior Authorization Familiar with Interqual ...

Elevance Health

Wound Care Utilization Management RN

Miami, FL · On-site

$39.34 - $56.20/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Wound Care Utilization Management RN Wound Care Utilization Management RN Virtual : This role ... Reviews Home based services for clinical appropriateness of continued care. * Performs reviews ...

Community Medical Group

APRN

Miami, FL · On-site

$106K - $145K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

As an APRN, you will play a vital role in delivering high-quality, comprehensive care to our ... Support utilization review and billing documentation processes * Provide clinical guidance and ...

Elevance Health

Wound Care Utilization Management RN

Miami, FL · On-site

$39.34 - $56.20/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Wound Care Utilization Management RN Virtual : This role enables associates to work virtually ... Reviews Home based services for clinical appropriateness of continued care. * Performs reviews ...

Elevance Health

Wound Care Utilization Management RN

Miami, FL · On-site

$39.34 - $56.20/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Wound Care Utilization Management RN Virtual : This role enables associates to workvirtually ... Reviews Home based services for clinical appropriateness of continued care. * Performs reviews ...

Integrated Home

Clinical Reviewer Nurse

Hollywood, FL · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Provide updates to Manager of Utilization Management for review What will you need to succeed: * State licensure as a LPN or RN * Minimum 2 years of prior experience in Utilization Management

TNAA TotalMed RN

Travel ER RN

Fort Lauderdale, FL · On-site

  • Medical

  • Dental

  • Vision

  • Retirement

TNAA TotalMed RN is seeking a travel nurse RN ED - Emergency Department for a travel nursing job in Fort Lauderdale, Florida. & Requirements * Specialty: ED - Emergency Department * Discipline: RN * ...

New

previous page

Showing results 41-60

All JobsRn Utilization Review Nurse JobsEntry Level Rn Utilization Review Nurse JobsEntry Level Rn Utilization Review Nurse Jobs in Miami, FL

Entry Level Rn Utilization Review Nurse information

See Miami, FL salary details

$20

$40

$65

How much do entry level rn utilization review nurse jobs pay per hour?

As of Aug 14, 2026, the average hourly pay for entry level rn utilization review nurse in Miami, FL is $40.44, according to ZipRecruiter salary data. Most workers in this role earn between $31.97 and $46.44 per hour, depending on experience, location, and employer.

What are the most commonly searched types of Rn Utilization Review Nurse jobs in Miami, FL?

The most popular types of Rn Utilization Review Nurse jobs in Miami, FL are:

What are popular job titles related to Entry Level Rn Utilization Review Nurse jobs in Miami, FL?

For Entry Level Rn Utilization Review Nurse jobs in Miami, FL, the most frequently searched job titles are:

What job categories do people searching Entry Level Rn Utilization Review Nurse jobs in Miami, FL look for?

The top searched job categories for Entry Level Rn Utilization Review Nurse jobs in Miami, FL are:

What cities near Miami, FL are hiring for Entry Level Rn Utilization Review Nurse jobs?

Cities near Miami, FL with the most Entry Level Rn Utilization Review Nurse job openings:

Entry Level Rn Utilization Review Nurse jobs near you
Infographic showing various Entry Level Rn Utilization Review Nurse job openings in Miami, FL as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 15% Part Time, and 2% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $84,116 per year, or $40.4 per hour.

Senior Registered Nurse

Integrated Resources INC

Miami, FL

Full-time

Re-posted 29 days ago

Job description

Company Description

Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.

Job Description
  • Responsible for completing medical necessity reviews using KFHP policies and procedures, reviewing inpatient and outpatient elective procedures requiring prior authorization, inpatient hospital stays, and requesting, assessing and appropriately channeling/facilitating discharge planning requests Consistently applies medical health benefit policy and medical management guidelines to authorize services. Identifies and refers requests for services to the appropriate Medical Director when guidelines are not met.
  • Receives requests for authorization of services, including inpatient hospital admissions, inpatient rehabilitation services, Skilled Nursing admission), home care home infusion services, outpatient and/or inpatient elective surgery, and referrals for specialty physician consultation with non-participating physician offices. Documents date that the request was received, nature of request, utilization determination (and events leading up to the determination).
  • Verifies and documents member eligibility for services.
  • Communicates and interacts in a real time bases via "live" encounters with providers and appropriate others to facilitate and coordinate the activities of the Utilization Management process(es).
  • Utilize technology and resources (systems, telephones, etc.) to appropriately support work activities. Voice mail as an adjunct to the daily work activities versus major reliance for giving and receiving information from providers; Accessing and applying Medical Guidelines for decision making prior to Medical Director/Physician Advisor referral.
  • Applies submitted information to KFHP authorization process (utilizing Milliman, USA, Interqual medical guidelines, Process Standards, Policies and Procedures, and Standard Operating Procedures). Authorizes services in accordance with medical and health benefits guidelines.
  • Coordinates with the referral source if insufficient information is not available to complete the authorization process. Advises the referral source and requests specific information necessary to complete the process. Documents the request and follows KFHP process for requesting additional information.
  • Refers cases to KFHP Medical Director for medical necessity review when medical information provided does not support the nurse review process for giving an approval of services requested.
  • Documents case activities for Utilization determinations and discharge planning in MeDecision in a real time manner (as events occur). Completes detail line as indicated. Completes ASF per policy.
  • Provides verbal/fax denial notification to the requesting provider as per policy. Generates denial letter in a timely manner.
  • Adheres to Process Standards, Standard Operating Procedures, and Policies and Procedures, as defined by specific UM role (Prior Authorization, Concurrent Review)
Qualifications

Current FL RN licensure

Registered Nurse graduated from an accredited Diploma, Associates Degree or Bachelor's Degree program

Minimum of 3 years of nursing experience, in related clinical setting, preferably critical care (e.g. ER, ICU)

Experience with Utilization Review and/or Prior Authorization

Familiar with Interqual Criterion

Knowledge of MS Office including Word, Excel, and Outlook

Additional Information

Riya Khem

Life Science Recruiter 

Integrated Resources, Inc.




Integrated Resources logo

About Integrated Resources

Sourced by ZipRecruiter

Integrated Resources Inc (IRI), based in Edison, NJ, US, is an esteemed player in the staffing solutions industry with a credible presence on their official website irionline.com. Notably, IRI provides a range of professional staffing services including contract, contract-to-hire, and direct hire solutions to a wide spectrum of industries such as healthcare, life sciences, manufacturing, financial, insurance, and others. Since its inception, IRI has been committed to delivering top-talent and optimum solutions to meet its clients' diverse needs.

Industry

Recruiting and staffing services

Company size

51 - 200 Employees

Headquarters location

Edison, NJ, US

Year founded

1996

View All Integrated Resources Jobs

Apply