Nevada Licensed Preservice Review Nurse

Job Summary

Nevada Licensed Preservice Review Nurse, responsible for reviewing provider requests for medical necessity and benefit level, working full-time remotely from 8:00 am to 5:00 pm PST.

Key Responsibilities

• Evaluate and assess requests for eligibility and product specifics
• Utilize criteria to approve, pend, or escalate cases to the medical director
• Maintain compliance with clinical review accuracy and regulatory standards

Required Qualifications

• A current, unrestricted RN license for the state of Nevada
• 2+ years of recent critical care, ER, and/or med-surg nursing experience
• Proficient with Microsoft Word and navigating a Windows environment
• Proven ability to conduct Internet searches and use Microsoft Outlook