Top 95 Work from home nurse Jobs in Florida

Care Review Clinician (RN) - Remote in FL
Molina Healthcare, Inc. —Florida
- $26.41 - $51.49 an hour
- Full-time
- Remote
- RN License
- Mid-level
- Critical & Intensive Care
- Health insurance
Care Review Clinician (RN) - Remote in FL
Molina Healthcare, Inc. —Miami, FL
- $26.41 - $51.49 an hour
- Full-time
- Remote
- RN License
- Mid-level
- Critical & Intensive Care
- Health insurance
Care Review Clinician (RN) - Remote in FL
Molina Healthcare, Inc. —Orlando, FL
- $26.41 - $51.49 an hour
- Full-time
- Remote
- RN License
- Mid-level
- Critical & Intensive Care
- Health insurance
Remote weight loss telehealth RN
SculptRx —Florida
- $30 - $35 an hour
- Part-time
- Remote
- RN License
- Mid-level
- Patient care
Quick Apply
Care Review Clinician (RN) - Remote in FL
Molina Healthcare, Inc. —Jacksonville, FL
- $26.41 - $51.49 an hour
- Full-time
- Remote
- RN License
- Mid-level
- Critical & Intensive Care
- Health insurance
CDI Specialist
HCTec —Florida
- Up to $95,000 a year
- Full-time
- Remote
- Nursing
- RN License
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
RN Telehealth
Total Life, Inc. —Florida
- Full-time
- Remote
- Spanish
- Nursing
- Psychiatry
Quick Apply
DRG Nurse Reviewer Appeals and Hearings- Remote
Gainwell Technologies —Florida
- $95,000 - $110,000 a year
- Full-time
- Remote
- RN License
- Presentation skills
- Travel
- Health insurance
- Tuition reimbursement
Case Manager, Registered Nurse (Oncology experience required)
CVS Health —Florida
- $54,095 - $155,538 a year
- Full-time
- Remote
- Spanish
- Nursing
- RN License
- Health insurance
- Dental insurance
Registered Nurse
Lucet —Florida
- $70,000 - $80,000 a year
- Remote
- Bilingual
- Nursing
- RN License
- Paid parental leave
- Disability insurance
Quick Apply
1d
Remote Registered Nurse (Remote Patient Monitoring & Chronic Care Management)
3:15 —Tampa, FL
- $55,000 - $65,000 a year
- Full-time
- Remote
- Background check
- RN License
- Computer literacy
- AD&D insurance
- Health insurance
Quick Apply
Compact RN Care Coach - Remote | High Performance
CircleLink Health —Florida
- Email
- Remote
- Nursing
- RN License
- Mid-level
Quick Apply
Second Level Reviewer I PRN Remote
AdventHealth Corporate —Altamonte Springs, FL
- $31.82 - $59.17 an hour
- PRN
- Remote
- Background check
- Nursing
- RN License
- Paid parental leave
- Disability insurance
Healthy First Steps RN - Daytona Beach, FL and surrounding areas
UnitedHealthcare —Daytona Beach, FL
- $29 - $52 an hour
- Full-time
- Remote
- Microsoft Word
- Spanish
- Nursing
- AD&D insurance
- Employee stock purchase plan
9d
Utilization Review Nurse
Cobalt Benefits Group LLC —Orlando, FL
- $90,000 - $98,000 a year
- Full-time
- Remote
- Nursing
- Microsoft Excel
- Microsoft Outlook
- Health savings account
- AD&D insurance
Quick Apply
Senior STARS Improvement, Clinical Professional
Humana —Florida
- $78,400 - $107,800 a year
- Full-time
- Remote
- Nursing
- Microsoft Excel
- RN License
- Paid parental leave
- Paid holidays
4d
Weekend Virtual Care Nurse
Concierge Home Care —Florida
- $20.00 - $22.25 an hour
- Weekends as needed
- Remote
- Background check
- Mid-level
- Home Health
- Health savings account
- Health insurance
Quick Apply
4d
Nurse Manager - Remote (RN Compact License Required)
Call 4 Health, Inc. —Florida
- Remote
- Nursing
- RN License
- 5 years
- Paid holidays
- Dental insurance
Medical Review Nurse - CMS RAC (Government audits)
Performant Financial Corporation —Plantation, FL
- $81,000 - $90,000 a year
- Full-time
- Remote
- RN License
- Computer literacy
- Writing skills
- Health savings account
- Paid holidays
Remote Behavioral Registered Nurse (RN)– Remote Care Manager
CareGenix Solutions LLC —Florida
- Part-time
- Remote
- Nursing
- RN License
- HIPAA
Quick Apply

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work from home nurse jobs near florida

Care Review Clinician (RN) - Remote in FL

Molina Healthcare, Inc. -
Florida

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Job Details

Full-time
$26.41 - $51.49 an hour

Benefits

Health insurance

Qualifications

Inpatient experience
RN License
Managed care organization experience
Acute care facility experience
Pre-authorization review for utilization management
Productivity software

Full Job Description

JOB DESCRIPTION

Must reside in Florida

Job Summary

Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

Assesses services for members to ensure optimum outcomes, cost-effectiveness and compliance with all state/federal regulations and guidelines.
Analyzes clinical service requests from members or providers against evidence based clinical guidelines.
Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures.
Conducts reviews to determine prior authorization/financial responsibility for Molina and its members.
Processes requests within required timelines.
Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient manner.
Requests additional information from members or providers as needed.
Makes appropriate referrals to other clinical programs.
Collaborates with multidisciplinary teams to promote the Molina care model.
Adheres to utilization management (UM) policies and procedures.

Required Qualifications

At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience.
Registered Nurse (RN). License must be active and unrestricted in state of practice.
Ability to prioritize and manage multiple deadlines.
Excellent organizational, problem-solving and critical-thinking skills.
Strong written and verbal communication skills.
Microsoft Office suite/applicable software program(s) proficiency.

Preferred Qualifications

Certified Professional in Healthcare Management (CPHM).
Recent hospital experience in an intensive care unit (ICU) or emergency room.

Utilization Management (UM) experience highly preferred.

#PJHS3

#LI-AC1

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Apply Now

Refine Your Search

work from home nurse jobs in florida

Care Review Clinician (RN) - Remote in FL

Care Review Clinician (RN) - Remote in FL

Care Review Clinician (RN) - Remote in FL

Remote weight loss telehealth RN

Care Review Clinician (RN) - Remote in FL

CDI Specialist

RN Telehealth

DRG Nurse Reviewer Appeals and Hearings- Remote

Case Manager, Registered Nurse (Oncology experience required)

Registered Nurse

Remote Registered Nurse (Remote Patient Monitoring & Chronic Care Management)

Compact RN Care Coach - Remote | High Performance

Second Level Reviewer I PRN Remote

Healthy First Steps RN - Daytona Beach, FL and surrounding areas

Utilization Review Nurse

Senior STARS Improvement, Clinical Professional

Weekend Virtual Care Nurse

Nurse Manager - Remote (RN Compact License Required)

Medical Review Nurse - CMS RAC (Government audits)

Remote Behavioral Registered Nurse (RN)– Remote Care Manager

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