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Medical Review Rn Jobs in Miami, FL (NOW HIRING)

GQR Global Markets

RN Case Manager

Pompano Beach, FL · On-site

$1.8K - $1.9K/wk

Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Margate ... Benefits: * Day 1 Insurance * Cigna medical, MetLife dental and vision insurance * License ...

GQR

RN - Case Manager

Margate, FL · On-site

$1.8K - $1.9K/wk

Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Margate ... Benefits: * Day 1 Insurance * Cigna medical, MetLife dental and vision insurance * License ...

Oscar Health

Utilization Review Nurse

Miami, FL · Remote

$35 - $45.94/hr

You will perform frequent case reviews, check medical records and speak with care providers ... Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate ...

TNAA TotalMed RN

Travel ER RN

Fort Lauderdale, FL · On-site

Emergency Room RNs will perform minor medical operations, advise patients and family on illnesses or injuries, and plan long-term care needs. Other responsibilities as an ER Travel Nurse include ...

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Medical Review Rn information

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$67

How much do medical review rn jobs pay per hour?

As of Aug 29, 2026, the average hourly pay for medical review rn in Miami, FL is $42.96, according to ZipRecruiter salary data. Most workers in this role earn between $32.88 and $51.06 per hour, depending on experience, location, and employer.

What is a Medical Review RN?

A Medical Review RN is a registered nurse who specializes in reviewing medical records and claims to ensure they meet established guidelines and standards. These nurses often work for insurance companies, government agencies, or healthcare organizations, evaluating the necessity, appropriateness, and efficiency of healthcare services provided to patients. Their role may include determining medical necessity, performing utilization reviews, and supporting appeals or audits. They use their clinical knowledge to interpret complex medical information and collaborate with healthcare providers to support accurate decision-making.

How does a Medical Review RN collaborate with other healthcare professionals during the review process?

A Medical Review RN often works closely with physicians, case managers, and insurance representatives to ensure that medical claims and treatment plans meet regulatory and clinical guidelines. Collaboration may involve participating in interdisciplinary meetings, discussing complex cases, and providing clinical expertise to support utilization management decisions. Effective communication and teamwork are essential, as you'll need to relay findings, request additional information, and sometimes clarify medical necessity with providers. This collaborative environment helps ensure quality care for patients while maintaining compliance with payer policies.

What are the key skills and qualifications needed to thrive as a Medical Review RN, and why are they important?

To thrive as a Medical Review RN, you need a strong clinical background, critical thinking skills, and an active RN license, often supported by experience in case management or utilization review. Familiarity with medical coding, claims management software, and knowledge of regulatory guidelines such as Medicare and Medicaid are typically required. Strong attention to detail, excellent written communication, and the ability to work independently are essential soft skills for this role. These competencies ensure accurate and compliant medical record reviews, which are critical for proper claims adjudication and regulatory adherence.

How to become a medical review RN?

To become a medical review RN, you need to earn a nursing license by completing an accredited nursing program and passing the NCLEX-RN exam. Additionally, gaining experience in clinical settings and obtaining certifications such as Certified Professional Coder (CPC) or specialized training in medical review can enhance qualifications for this role.

What cities near Miami, FL are hiring for Medical Review Rn jobs?

Cities near Miami, FL with the most Medical Review Rn job openings:

Medical Review Rn jobs near you
Infographic showing various Medical Review Rn job openings in Miami, FL as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 15% Part Time, and 6% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $89,350 per year, or $43 per hour.

Utilization Review Registered Nurse

Healthcare Support Staffing

Sunrise, FL • On-site

Full-time

Re-posted 11 days ago

Job description

Company Description

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Job Description

Our expanding managed care company is seeking RNs for positions in concurrent review and prior authorizations for our Sunrise office. This is a M-F daytime (no holidays/no weekends) fulltime position. This position is specific to managed care case management and is an excellent opportunity to start a career with one of the country's leading HMO's. Prior Authorizations Nurse responsibilities include speaking with providers and handling authorizations for surgery and medical services.

Concurrent Review Nurse responsibilities include reviewing inpatient admissions to determine if patients meet criteria to be in the hospital.

Salary dependent upon experience -- typical range 60K-72K


Qualifications

*MUST be Florida-licensed Registered Nurse and live in Broward or Dade counties

*5 years minimum nursing experience

*Must have 2 years minimum experience in at least one of the following: utilization review from another managed care company; experience in a medical setting handling coordinating with insurance companies in obtaining prior authorizations; and/or experience working as a concurrent review nurse for a hospital *Strong computer and communication skills

*InterQual experience strongly preferred

*Understanding of Medicare and Medicaid guidelines preferred


Additional Information

-Salary range 60K-72K

-Excellent opportunity to begin a career with one of Florida's leading health plans with excellent benefits

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About Healthcare Support

Sourced by ZipRecruiter

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.

Industry

Recruiting and staffing services

Company size

201 - 500 Employees

Headquarters location

Maitland, FL, US

Year founded

2003

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