Multi-State Licensed Clinical Care Reviewer

Job Summary

A company is looking for a Clinical Care Reviewer II - RN with Multi-State License and UM Experience.

Key Responsibilities

• Process medical necessity reviews for healthcare service authorization
• Coordinate care and assist with discharge planning activities
• Engage with care partners and medical directors for transitions and quality issues

Required Qualifications, Training, and Education

• Associate of Science (A.S) in an accredited registered nursing (RN) program
• Three (3) years of clinical experience required
• Preferred experience in med/surgical, emergency acute clinical care, or home health
• Utilization Management/Utilization Review experience preferred
• Current, unrestricted Registered Nurse (RN) Licensure in state(s) of practice required