Top 19 Mds nurse Jobs in Orlando, Fl

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
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
Clinical Reimbursement Specialist RN/LPN
Terrace of St. Cloud —Saint Cloud, FL
- $90,000 - $100,000 a year
- Full-time
- Nursing
- Skilled nursing facility
- RN License
Quick Apply
10d
MDS Manager
SHCM Corporate —Casselberry, FL
- RN License
- 5 years
- Analysis skills
Quick Apply
3h
Care Review Clinician (RN) Remote
Molina Healthcare —Mid Florida, FL
- $26.41 - $51.49 an hour
- 8 hour shift
- RN License
- Mid-level
- Critical & Intensive Care
- Health insurance
NURSING PROGRAM SPECIALIST - MDS - 50556088
The State of Florida —Orlando, FL
- $72,113.08 a year
- Full-time
- Background check
- CPR Certification
- Nursing
- Paid holidays
- Health insurance
9d
REGISTERED NURSE
The State of Florida —Orlando, FL
- $67,742.74 a year
- Overtime
- CPR Certification
- Nursing
- Skilled nursing facility
- Paid holidays
- Health insurance
MDS Coordinator - RN
Regents Park of Winter Park —Winter Park, FL
- Full-time
- Skilled nursing facility
- RN License
- Mid-level
- Travel reimbursement
- Health insurance
Quick Apply
3P-11P Charge Nurse RN
Terrace of Kissimmee —Kissimmee, FL
- From $32 an hour
- Weekends as needed
- Background check
- Nursing
- RN License
- On-the-job training
Quick Apply
Registered Nurse/ Floor Nurse
Terrace of Kissimmee —Kissimmee, FL
- From $32 an hour
- Weekends as needed
- Background check
- Nursing
- RN License
- On-the-job training
Quick Apply
Wound Care Nurse (LPN)
Rehabilitation Center of Orlando —Orlando, FL
- $29 - $31 an hour
- Full-time
- Background check
- Skilled nursing facility
- Mid-level
Quick Apply
3d
MDS Nurse Assistant RN/LPN
Terrace of St. Cloud —Saint Cloud, FL
- From $30 an hour
- Weekends as needed
- Background check
- Nursing
- RN License
Quick Apply
Registered Nurse/ Floor Nurse
Terrace of St. Cloud —Saint Cloud, FL
- From $32 an hour
- Part-time
- Background check
- Nursing
- RN License
- On-the-job training
Quick Apply
3P-11P Charge Nurse RN/LPN
Terrace of St. Cloud —Saint Cloud, FL
- From $30 an hour
- Weekends as needed
- Background check
- Nursing
- RN License
- On-the-job training
Quick Apply
Licensed Practical Nurse/ Floor Nurse
Terrace of St. Cloud —Saint Cloud, FL
- From $30 an hour
- Part-time
- Background check
- Nursing
- RN License
- On-the-job training
Quick Apply

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Care Review Clinician (RN) - Remote in FL

Molina Healthcare, Inc. -
Orlando, FL

Apply Now

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

mds nurse jobs in orlando, fl

Care Review Clinician (RN) - Remote in FL

Care Review Clinician (RN) - Remote in FL

Clinical Reimbursement Specialist RN/LPN

MDS Manager

Care Review Clinician (RN) Remote

NURSING PROGRAM SPECIALIST - MDS - 50556088

REGISTERED NURSE

MDS Coordinator - RN

3P-11P Charge Nurse RN

Registered Nurse/ Floor Nurse

Wound Care Nurse (LPN)

MDS Nurse Assistant RN/LPN

Registered Nurse/ Floor Nurse

3P-11P Charge Nurse RN/LPN

Licensed Practical Nurse/ Floor Nurse

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