Arizona Licensed Care Review Clinician
Job Summary
Supporting the Arizona state Plan, the full-time Arizona Licensed Care Review Clinician will assess clinical member services for medical necessity, ensuring compliance with guidelines while working remotely from Arizona.
Key responsibilities
- Assesses services for members to ensure optimum outcomes and compliance with regulations
- Analyzes clinical service requests against evidence-based clinical guidelines
- Conducts reviews for prior authorization and collaborates with multidisciplinary teams
Required qualifications
- At least 2 years of experience in hospital acute care, inpatient review, or managed care
- Active and unrestricted Registered Nurse (RN) license in Arizona
- Ability to prioritize and manage multiple deadlines effectively
- Strong organizational and critical-thinking skills
- Proficiency in Microsoft Office suite and applicable software programs
Complete Job Description
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