Nevada Licensed Clinical Care Reviewer

Job Summary

A company is looking for a Clinical Care Reviewer II - Nevada Licensed - RN - PST Hours.

Key Responsibilities

• Process medical necessity reviews for healthcare service authorizations and assist with discharge planning activities
• Coordinate care and engage with collaborative partners to facilitate transitions to appropriate care levels
• Maintain knowledge of regulations and identify quality issues for referral to Quality Improvement

Required Qualifications, Training, and Education

• Associates of Science (A.S) from an accredited registered nursing (RN) degree 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