Clinical Reviewer (LPN, LVN, RN)

Job Summary

To support a growing team, the full-time remote Clinical Reviewer (LPN, LVN, RN) will review medical records against criteria to ensure medical appropriateness while managing workload and quality monitoring activities.

Key responsibilities

• Assures accuracy and timeliness of review-type cases within contract requirements
• Assesses and adjusts daily workload and schedules to meet departmental demands
• Functions as a liaison for provider customer service issues and problem resolution

Required qualifications

• Active, unrestricted LPN, LVN, or RN license from the state of residence
• Associate's degree or practical/vocational nursing diploma/certificate
• 1+ years of experience in Utilization Management/Utilization Review
• Medical record abstracting skills and knowledge of medical terminology
• Strong clinical assessment and critical thinking skills