Arkansas Licensed Clinical Reviewer - RN

Job Summary

A company is looking for a Clinical Reviewer - RN (Personal Care) - PRN (Remote in Arkansas).

Key Responsibilities

• Utilizes clinical expertise to review medical records and complete prior authorizations for Personal Care services
• Collaborates with clinical leadership to monitor provider trends and recommend internal policies and procedures
• Maintains client privacy and ensures adherence to ethical, legal, and regulatory standards

Required Qualifications

• Active, unrestricted Registered Nurse (RN) License in any state or an RN compact state license
• Associate's or Bachelor's degree (or Diploma) in Nursing
• 2+ years of clinical experience in an acute or home health environment
• 1+ years of experience in Utilization Review (UR), Utilization Management (UM), or Prior Authorization
• 1+ years of knowledge of medical records, medical terminology, and disease processes