Connecticut Licensed Clinical Reviewer

Job Summary

A company is looking for a Clinical Reviewer, RN/LPN (Remote).

Key Responsibilities

• Review requests for services including admissions, discharges, and continued stays for compliance with clinical criteria and policies
• Issue approvals, denials, or recommendations based on contract requirements
• Complete documentation of activities within contract systems and communicate with relevant stakeholders

Required Qualifications

• High School Degree or equivalent required
• Minimum 1 year of clinical experience required
• Minimum of 3 years of experience in the behavioral or mental health field
• Hold an active and unrestricted license as a Registered Nurse (RN) or Licensed Practical Nurse (LPN)
• Preferred knowledge of community support programs and long-term care assessment