cloudteam

Medical-Clinical Support-Nursing

Posted on

October 8, 2025

Job Type

Contract

Role Type

Clinical Operations

License

RN

State License

Compact / Multi-State

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Company Description

Cloudteam's concept was founded by long-time friends Lou Exline and Kris Kocan in July of 2011. Prior to launching cloudteam, Lou was on the business and Kris on the technical side of consulting. Over a long dinner, they discussed how frustrated they were with the IT consulting industry. The discussion varied, from consultants receiving relentless calls from competing consulting company recruiters, all trying to fill the same client positions; to customers interviewing and selecting a person for a position and another showing up. Spending hours writing all the issues down on several napkins, they decided to design a system and process that would eliminate these issues and change the industry. They set up shop in Titusville, FL and started to go to work, employing a small, motivated development team and investing a great deal of time and money. Cloudteam’s goal is to address the issues that exist in the industry today. Consultants and customers are going to enjoy our emphasis on qualifying, transparency, training, privacy and service. Not to mention our ability to reduce margins by eliminating friction. Eliminating friction means consultants make more and customers pay less!

Job Description

FLSA: Non-Exempt Shift: Monday–Friday, 8am–5pm EST. Some weekend work may be required; flex weekday scheduling permitted (no more than 40 hours/week). Contract: Contract only (no conversion to perm at this time). Equipment: Provided and mailed to employee. Location: Remote (Florida only).

Requirements

Active Florida RN License (unrestricted) or Nursing Compact License (required). Bachelor’s degree in Nursing (required). 2+ years of related nursing experience, or equivalent combination of transferable education and experience. CMS experience with review of all organization determinations, including pharmacy reviews. Hands-on experience with Jiva, Siebel, and Diamond systems. Ability to work remotely within Florida. Preferred Qualifications: Managed care experience, including use of InterQual, NCD, and LCD review criteria. Familiarity with regulatory agencies and Medicare Advantage plans. Prior Florida Blue (FLBL) experience. Ability to work effectively across multiple screens and systems. Licenses & Certificates: Florida RN License (or Compact State Licensure) – Required. Florida Driver’s License (valid and in-state) – Required.

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Responsibilities

The Medical-Clinical Support-Nursing – Pre/Post Service Medical Review Nurse (RN) plays a critical role in supporting clinical decision-making through the review of appeals and post-service cases. This position ensures timely, accurate, and compliant determinations by reviewing cases against CMS, Medicare Advantage, InterQual, and other medical review criteria. The nurse is responsible for documenting findings, drafting determination statements, and collaborating with medical directors and regulatory teams to meet strict compliance standards.

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