RN Clinical Care Reviewer
This job has been removed
Location: Remote
Compensation: To Be Discussed
Reviewed: Mon, Mar 24, 2025
This job expires in: 21 days
Job Summary
A company is looking for a Clinical Care Reviewer, Utilization Management, RN.
Key Responsibilities
- Evaluate medical necessity for inpatient and outpatient services in accordance with clinical guidelines and regulatory requirements
- Collaborate with healthcare providers to facilitate timely authorizations and optimize patient care
- Analyze medical records and clinical data to ensure compliance with regulatory and payer guidelines
Required Qualifications
- Associate's Degree in Nursing (ASN) required; Bachelor's Degree in Nursing (BSN) preferred
- An active compact state Registered Nurse (RN) license in good standing required
- 3+ years of diverse clinical experience in settings such as ICU, ED, or home health care
- Proficiency in Electronic Medical Record Systems
- Strong understanding of utilization review processes and regulatory compliance
COMPLETE JOB DESCRIPTION
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Company Overview
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