Clinical Review Nurse Specialist

1 week ago


Coconut Creek, Florida, United States Centers Plan for Healthy Living Full time

Centers Plan for Healthy Living is seeking a skilled Registered Nurse to fill a Clinical Review position. The ideal candidate will have a graduate degree from an accredited School of Nursing and 3-5 years of home care experience.

This role involves reviewing admission, resumption, recert, and discharge assessments for Medicare, Medicaid, and Medicare/Medicaid HMO cases to ensure diagnostic information can be substantiated by medical records.

  • Audit Medicare/non-Medicare charts to maintain compliance with Federal and State regulations.
  • Review OASIS and visit documentation for errors and inconsistencies related to clinical documentation.
  • Apply ICD-10-CM coding rules and regulations to the review process.
  • Discuss findings with supervisors and advise on needed corrections.
  • Develop effective working relationships with the healthcare team.

We estimate the salary for this position to be around $65,000-$80,000 per year, depending on experience.


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