Top 123 Nurse liaison Jobs in Miami, Fl

Utilization Management Nurse
Solis Health Plans —Miami, FL
- $60,000 - $70,000 a year
- Full-time
- Spanish
- Nursing
- RN License
- Health savings account
- Disability insurance
Quick Apply
10h
Nurse Navigator, MNI Office, FT,8:00am - 4:30pm
Baptist Health South Florida —Miami, FL
- $80,516.80 - $107,087.34 a year
- Full-time
- Bilingual
- Nursing
- RN License
- Wellness program
- Health insurance
Nurse Navigator, BHMG Cardiology, FT,8:30A-5P
Baptist Health South Florida —Miami, FL
- $80,516.80 - $107,087.34 a year
- Full-time
- Bilingual
- Nursing
- RN License
- Wellness program
- Health insurance
Clinical Liaison - Inpatient Rehab
West Gables Rehabilitation Hospital —Miami, FL
- Full-time
- Acute care
- Spanish
- RN License
- Dental insurance
- Paid time off
Quick Apply
RN Patient Advocate Position- Part-Time
Healthcare Advisor Nan —Miami, FL
- From $60 an hour
- Part-time
- RN License
- 5 years
- English
- Flexible schedule
Quick Apply
11d
School Based Health Registered Nurse (RN)
COMMUNITY HEALTH OF SOUTH FLORIDA INC —Miami, FL
- $31.77 - $41.78 an hour
- School experience
- Spanish
- CPR Certification
- Vision insurance
Quick Apply
Registered Nurse - Admissions Discharge - Full Time
University of Miami —Miami, FL
- Full-time
- CPR Certification
- Nursing
- RN License
- Health insurance
- Dental insurance
13d
RN Clinical Liaison
Gentiva —Miami, FL
- Full-time
- CPR Certification
- Nursing
- Management
Quick Apply
6d
Nurse Navigator, BHMG Interventional Radiology
Baptist Health Medical Group —Miami, FL
- $80,516.80 - $107,087.34 a year
- Bilingual
- Nursing
- RN License
- Wellness program
- Health insurance
Nurse Navigator, BHMG Endocrinology
Baptist Health Medical Group —Doral, FL
- $87,755.20 - $116,714.42 a year
- Spanish
- Nursing
- Microsoft Excel
- Wellness program
- Health insurance
Care Transition Coordinator, Full-Time, Days
Jackson Health —Miami, FL
- Full-time
- Nursing
- Clean driving record
- BLS Certification
Quick Apply
Nurse Navigator, BHMG Cardiology
Baptist Health Medical Group —Miami, FL
- $80,516.80 - $107,087.34 a year
- Bilingual
- Nursing
- RN License
- Wellness program
- Health insurance
Registered Nurse 1 - Ortho Clinic
University of Miami —Miami, FL
- Full-time
- Nursing
- Vital signs
- Surgery
- Health insurance
- Dental insurance
Nurse Navigator, Cardiology Sleep Medicine
Baptist Health Medical Group —Miami, FL
- $80,516.80 - $107,087.34 a year
- Bilingual
- Nursing
- RN License
- Wellness program
- Health insurance
Registered Nurse (2)
University of Miami —Miami, FL
- Full-time
- Nursing
- Vital signs
- RN License
- Health insurance
- Dental insurance
4d
Registered Nurse, Full Time Day
Kindred Hospital South Florida - Coral Gables —Coral Gables, FL
- Full-time
- Nursing
- RN License
- Computer literacy
Clinical Liaison RN
AccentCare, Inc. —Miami, FL
- $80,000 - $100,000 a year
- Full-time
- RN License
- Hospital
- Inpatient
- Health savings account
- Paid holidays
Quick Apply
Nurse Navigator, GPS High Risk, Full Time, Hybrid
University of Miami —Miami, FL
- Full-time
- Hybrid work
- Nursing
- RN License
- Mid-level
- Health insurance
- Dental insurance
12d
Patient Navigator - Part Time
University of Miami —Miami, FL
- Part-time
- High school diploma or GED
- Computer skills
- 1 year
- Health insurance
- Dental insurance
Registered Nurse 2 - Mohs - Full Time
University of Miami —Miami, FL
- Full-time
- CPR Certification
- Nursing
- Vital signs
- Health insurance
- Dental insurance

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Utilization Management Nurse

Solis Health Plans -
Miami, FL

Quick Apply

Job Details

Full-time
$60,000 - $70,000 a year
10 hours ago

Benefits

Health savings account
Disability insurance
Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance
401(k) matching

Qualifications

Spanish
Nursing
RN License
English
Bachelor's degree

Full Job Description

About us:

Solis Health Plans is a new kind of Medicare Advantage Company. We provide solutions that are more transparent, connected and effective for both our members and providers. Solis was born out of a desire to provide a more personal experience throughout all levels of the healthcare journey. Our team consists of expert individuals that take pride in delivering quality service. We believe in a culture that collaborates and supports one another, and where success is interlinked and each employee is valued. Please check out our company website at www.solishealthplans.com to learn more about us!

**Bilingual in English and Spanish is required**

Full benefits package offered on the first on the month following date of hire including: Medical, Dental, Vision, 401K plan with a 100% company match!

Our company has doubled size and we have experienced exponential growth in membership from 2,000 members to over 20,000 members!

Join our winning Solis Team!

Position is fully onsite Monday-Friday.

Location: 9250 NW 36th St, Miami, FL 33178.

Position Summary:

Under the supervision of the Health Services Director, the Utilization Management Nurse (LPN or RN) uses a multidisciplinary approach to organize, coordinate, monitor, evaluate, create and manage organization determinations and authorizations. These service requests will focus on selected complex medical and psychosocial needs of Solis Health Plans members. The UM Nurse is responsible for assuring the receipt of high quality, cost efficient medical outcomes for enrollees. This role works with Medical Directors, Authorization Coordinators and Service Coordinators to perform first level review to pre-certify elective services, procedures and tests utilizing established Care Coordination polices and protocols, Solis Health Plans benefit criteria, applicable regulatory review criteria and nationally accepted criteria for medical necessity determination.

Main Key Responsibilities:

Conduct concurrent and retrospective utilization review for inpatient, observation or SNF services.
Conducts clinical reviews of proposed services against appropriate criteria/guidelines to determine medical necessity, benefit eligibility, and network contract status.
Work with Medical Directors, Program Leadership and Solis Health Plans Provider Relations Teams to identify and mitigate facility barriers associated with the ability to make timely decisions.
Identify, align and utilize health plan and community resources that impact high-risk/high cost care.
Act as liaison between assigned facilities, members/families, and Solis Health Plans. Clarify policies/procedures and member benefits as needed. Authorizes services, coordinates care, and ensures timeliness and coordination of healthcare services, in compliance with department and regulatory standards, seeking supplemental services when appropriate or when needed.
Assess enrollee needs and monitor progress toward goals at all times, communicating findings and status with members of the enrollee’s primary care team.
Ensure optimal delivery of safe quality health care to members, while maximizing resources and containing costs, and facilitate continual patient-centered and outcome-driven health performance improvement activities.
Review enrollees with the Medical Directors and Primary Care Teams and advocates for Administration Exception considerations as appropriate.
Facilitate communications between the facility, providers, and the PCT in order to effect and influence a safe and effective discharge plan and care plan for the enrollee.

Qualifications:

Graduate from an accredited school of nursing, or Bachelors (or advanced) degree in nursing.
Active and unrestricted licensure as a Registered Nurse in Florida.
A minimum of three to five years clinical experience as a Registered Nurse in a clinical setting required.
2 years’ experience as a Utilization Management nurse in a managed care payer preferred.
One year experience as a case manager in a payer or facility setting highly preferred.
Discharge planning experience highly preferred.

What Sets Us Apart:

Join Solis Health Plans as a Utilization Management Nurse and become a catalyst for positive change in the lives of our members. At Solis, you will be part of a locally rooted organization deeply committed to understanding and serving our communities. If you are eager to embark on a purpose-driven career that promises growth and the chance to make a significant impact, we encourage you to explore the opportunities available at Solis Health Plans. Join us and be the difference!

Job Type: Full-time

Pay: $60,000.00 - $70,000.00 per year

Benefits:

401(k)
401(k) matching
Dental insurance
Disability insurance
Health insurance
Health savings account
Paid time off
Vision insurance

Ability to Commute:

Miami, FL 33178 (Required)

Ability to Relocate:

Miami, FL 33178: Relocate before starting work (Required)

Work Location: In person

Quick Apply

Refine Your Search

nurse liaison jobs in miami, fl

Utilization Management Nurse

Nurse Navigator, MNI Office, FT,8:00am - 4:30pm

Nurse Navigator, BHMG Cardiology, FT,8:30A-5P

Clinical Liaison - Inpatient Rehab

RN Patient Advocate Position- Part-Time

School Based Health Registered Nurse (RN)

Registered Nurse - Admissions Discharge - Full Time

RN Clinical Liaison

Nurse Navigator, BHMG Interventional Radiology

Nurse Navigator, BHMG Endocrinology

Care Transition Coordinator, Full-Time, Days

Nurse Navigator, BHMG Cardiology

Registered Nurse 1 - Ortho Clinic

Nurse Navigator, Cardiology Sleep Medicine

Registered Nurse (2)

Registered Nurse, Full Time Day

Clinical Liaison RN

Nurse Navigator, GPS High Risk, Full Time, Hybrid

Patient Navigator - Part Time

Registered Nurse 2 - Mohs - Full Time

I want to receive the latest job alert for nurse liaison in miami, fl

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