Job Description

Requisition No: 878044

Agency: Financial Services

Working Title: REGISTERED NURSING CONSULTANT - 43001996

Pay Plan: Career Service

Position Number: 43001996

Salary: $60,000.00 - $70,000.00

Posting Closing Date: 07/01/2026

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****INTERNAL AGENCY EMPLOYMENT OPPORTUNITY*****

DIVISION: RISK MANAGEMENT

BUREAU: RISK FINANCING & LOSS PREVENTION

CITY: TALLAHASSEE

COUNTY: LEON

Requirements:

• Licensure as a Registered Professional Nurse in accordance with Chapter 464, Florida Statutes, or eligible to practice nursing in accordance with Florida Administrative Code 210-8.27, and four years of professional nursing experience.
• A post-secondary degree from an accredited college or university with a major in nursing can substitute for one year of the required general professional nursing experience.
• A master’s degree from an accredited college or university in nursing can substitute for two years of the required general professional nursing experience.

Preferences:

• Experience in Workers’ Compensation

• Experience reviewing medical records and conducting medical audits

• Experience in contract management and/or contract monitoring

Minimum Qualifications for this position include the following REQUIRED ENTRY LEVEL KNOWLEDGE, SKILLS, AND ABILITIES:

• Knowledge of nursing principles, practices, and techniques.
• Knowledge of human anatomy and physiology.
• Knowledge of methods of compiling, organizing and analyzing data.
• Ability to develop and implement various program monitoring methodologies and techniques.
• Ability to provide in-service training on medical and health care services, patient assessments, and utilization practices.
• Ability to develop program policy, procedures, manuals, administrative rules and agreements.
• Ability to understand and apply applicable rules, regulations, policies and procedures.
• Ability to prioritize workload.
• Ability to plan, organize and coordinate work assignments.
• Ability to analyze various reports.
• Ability to formulate and monitor nursing standards and operating policies and procedures.
• Ability to establish and maintain effective working relationships with others.
• Ability to communicate effectively verbally and in writing.
• Ability to determine work priorities, assign work, and ensure proper completion of work assignments.

BRIEF DESCRIPTION OF DUTIES:

Provide monitoring and oversight of the Pharmacy Benefit Manager contractor by conducting audits on prescription payments, reviewing reports, completing a monthly monitoring checklist, audit and refund tracking, maintaining an organized and complete contract folder, reviewing invoices, and communicating with the contractor on a routine basis.

Provide monitoring and oversight of medical bill review, re-pricing, and pre-certification programs by conducting audits on selected medical bills being processed by the Medical Bill Review contractor.

Provide monitoring and oversight of medical case management activities by conducting audits on selected claims in the Medical Case Management contractor’s system.

Provide nursing consultation and medical expertise to Division staff on workers' compensation claims concerning but not limited to: evaluating medical care and supplies furnished by providers, appropriateness of the level of service provided, treatment rendered in relationship to the injury, codes billed versus the treatment actually rendered, and monitoring rehabilitation services.

Perform related work as required.

Special notes

The annual salary for this position will range from $60,000 - $70,000 depending upon experience and qualifications.

Scheduled working hours will be between the core business hours of 7:30 a.m. and 5:00 p.m., Monday through Friday.

Responses to Qualifying Questions that are not supported by the education, professional certifications or job experience portion of the application submitted for this advertisement will result in the application being screened out of the selection process.

This position requires a security background check, including fingerprint as a condition of employment.

Employees of the Department of Financial Services are paid on a monthly pay cycle.

Candidates requiring a reasonable accommodation, as defined by the Americans with Disabilities Act, must notify the agency hiring authority and/or People First Service Center (1-866-663-4735). Notification to the hiring authority must be made in advance to allow sufficient time to provide the accommodation.

The State of Florida supports a Drug-Free workplace. All employees are subject to reasonable suspicion drug testing in accordance with Section 112.0455, F.S., Drug-Free Workplace Act.

VETERANS’ PREFERENCE. Pursuant to Chapter 295, Florida Statutes, candidates eligible for Veterans’ Preference will receive preference in employment for Career Service vacancies and are encouraged to apply. Certain service members may be eligible to receive waivers for postsecondary educational requirements. Candidates claiming Veterans’ Preference must attach supporting documentation with each submission that includes character of service (for example, DD Form 214 Member Copy #4) along with any other documentation as required by Rule 55A-7, Florida Administrative Code. Veterans’ Preference documentation requirements are available by clicking here All documentation is due by the close of the vacancy announcement.