Description
Solis Health Plans is hiring a Utilization Management Nurse to work onsite Monday through Friday in Miami, Florida. The role reviews and authorizes complex medical and psychosocial services, conducts concurrent and retrospective utilization reviews, assesses medical necessity and benefit eligibility, coordinates care with facilities and providers, supports discharge planning, and advocates for timely and cost-efficient member outcomes. The position requires bilingual English and Spanish ability, Florida RN licensure, a nursing degree or accredited nursing school graduation, and three to five years of clinical RN experience; managed-care utilization management and case-management experience are preferred.
