Remote Clinical Review RN — Appeals & Medical Necessity; FL
Miami, Miami-Dade County, Florida, 33101, USA
Listed on 2026-11-01
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Nursing
RN Nurse, Clinical Nurse Specialist, Nurse Educator
NTT DATA, Inc. is seeking a Clinical Reviewer Specialist for a fully remote position based in Florida. You will perform clinical and medical necessity reviews for member and provider appeals, evaluating records and criteria to support Medical Director recommendations while ensuring regulatory and NCQA compliance.
The role requires RN licensure (Florida or compact), 3+ years in appeals or related operations, and ability to work U.S. daytime hours.
We would love to welcome a new Remote Clinical Review RN — Appeals & Medical Necessity (FL) to our team in Tallahassee, FL, United States.
This posting is for the Remote Clinical Review RN — Appeals & Medical Necessity (FL) role at NTT DATA, Inc., based in Tallahassee, FL, United States.
We are looking to fill the Remote Clinical Review RN — Appeals & Medical Necessity (FL) position at NTT DATA, Inc. in Tallahassee, FL, United States.
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