Mississippi Licensed Care Review RN

Job Summary

Mississippi Licensed Care Review RN, responsible for assessing clinical services for members to ensure medical necessity and compliance with guidelines in a full-time position.

Key Responsibilities

• Assess services for members to ensure optimum outcomes and compliance with regulations
• Analyze clinical service requests against evidence-based guidelines and determine prior authorization
• Collaborate with multidisciplinary teams and adhere to utilization management policies

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 the state of practice
• Ability to prioritize and manage multiple deadlines
• Proficiency in Microsoft Office and applicable software programs