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Remote Rn Case Review Jobs in Florida (NOW HIRING)

York Risk Services

RN Field Case Manager

Orlando, FL · On-site +1

$72K - $92K/yr

Must be an RN and prefers 1.5 years of prior Field Case Manager workers compensation experience ... remote work environment that allows face to face interaction with injured workers and medical ...

York Risk Services

RN Field Case Manager

Miami, FL · On-site +1

$74K - $94K/yr

Must be an RN and prefers 1.5 years of prior Field Case Manager workers compensation experience ... remote work environment that allows face to face interaction with injured workers and medical ...

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Remote Rn Case Review information

What is the difference between Remote Rn Case Review vs Remote Rn Utilization Review?

AspectRemote Rn Case ReviewRemote Rn Utilization Review
CredentialsRegistered Nurse (RN), licensure, case review certificationsRegistered Nurse (RN), licensure, utilization review certifications
Work EnvironmentRemote, healthcare settings, insurance companiesRemote, healthcare settings, insurance companies
Employer & IndustryHospitals, insurance firms, healthcare providersInsurance companies, healthcare management organizations

Remote Rn Case Review and Remote Rn Utilization Review roles both involve remote nursing work within the healthcare and insurance industries. While they share similar credentials and work environments, case review focuses on evaluating individual patient cases, whereas utilization review assesses the necessity and appropriateness of healthcare services. Understanding these distinctions helps job seekers identify the right role based on their skills and career goals.

What are the most commonly searched types of Rn Case Review jobs in Florida? The most popular types of Rn Case Review jobs in Florida are:
What are popular job titles related to Remote Rn Case Review jobs in Florida? For Remote Rn Case Review jobs in Florida, the most frequently searched job titles are:
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What cities in Florida are hiring for Remote Rn Case Review jobs? Cities in Florida with the most Remote Rn Case Review job openings:
Remote Rn Case Review jobs near you
Utilization Review Registered Nurse, Case Management, FT, 07A-7:30P Local Remote

Utilization Review Registered Nurse, Case Management, FT, 07A-7:30P Local Remote

Baptist Health South Florida

Boca Raton, FL • Remote

$73K - $96K/yr

Full-time

This job post has expired today. Applications are no longer accepted.

Baptist Health South Florida rating

7.9

Company rating: 7.9 out of 10

Based on 96 frontline employees who took The Breakroom Quiz

1st of 23 rated health and beauty retailers

Job description

The purpose of this position is to conduct initial, concurrent, retrospective chart review for clinical financial resource utilization. Coordinates with healthcare team for optimal/efficient patient outcomes, while decreasing length of stay (LOS) and avoid delays and denied days. They are accountable for a designated patient caseload and provides intervention, coordination to decrease avoidable delays, denial of reimbursement. Specific functions within this role include: Screens pre-admission, admission process using established criteria for all points of entry. Facilitates communication between payers, review agencies, healthcare team. Identify delays in treatment or inappropriate utilization and serves as a resource. Coordinates communication with physicians. Identify opportunities for expedited appeals and collaborates to resolve payer issues. Ensures/Maintains effective communication with Revenue Cycle Departments.Estimated salary range for this position is $73860.80 - $96019.04 / year depending on experience.

Degrees:

  • Associates.

Licenses & Certifications:

  • MCG Care Guidelines Specialist.
  • Registered Nurse.

Additional Qualifications:

  • RNs hired prior to 2-2012 (10/1/2017 at Bethesda or 7/1/2019 at BRRH) with an Associates Degree in Nursing are not required to have a BSN to continue their non-leadership role as an RN.
  • however, they are required to complete the BSN within 3 years of job entry date.
  • MCG Specialist Certification ISC/HRC required within 12 months of job entry date.
  • 3 years of Nursing experience preferred.
  • Excellent written, interpersonal communication and negotiation skills.
  • Strong critical thinking skills and the ability to perform clinical/chart review abstract information efficiently.
  • Strong analytical, data management and computer skills.
  • Strong organizational and time management skills, as evidenced by capacity to prioritize multiple tasks and role components.
  • Current working knowledge of payer and managed care reimbursement preferred.
  • Ability to work independently and exercise sound judgment in interactions with the health care team and patients/families.
  • Knowledgeable in local, state, and federal legislation and regulations.
  • Ability to tolerate high volume production standards.

Minimum Required Experience: 

3 Years of Nursing experience with 1 year of previous Utilization Review experience required. 

What Baptist Health South Florida employees say

Pay

Benefits

Hours and flexibility

Workplace

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About Baptist Health South Florida

Sourced by ZipRecruiter

Baptist Health South Florida is the largest healthcare organization in the region, with 12 hospitals, more than 27,000 employees, 4,000 physicians and 100 outpatient centers, urgent care facilities and physician practices spanning across Miami-Dade, Monroe, Broward and Palm Beach counties. Baptist Health has internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences. A not-for-profit organization supported by philanthropy and committed to its faith-based charitable mission of medical excellence, Baptist Health has been recognized by Fortune as one of the 100 Best Companies to Work For in America and by Ethisphere as one of the World's Most Ethical Companies.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Miami, FL, US

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