Oklahoma Licensed Review Nurse

Job Summary

Working remotely from anywhere in the U.S., the part-time Oklahoma Licensed Review Nurse will perform clinical coverage review services, interpret mandates, and communicate benefit determinations while collaborating with healthcare providers and team members.

Key responsibilities

• Perform clinical coverage review services, interpreting state and federal mandates and relevant clinical information
• Communicate benefit coverage determinations to healthcare providers and members, obtaining additional clinical information as needed
• Collaborate with Medical Directors and non-clinical partners while meeting individual and team performance metrics

Required qualifications

• Current unrestricted RN license in Oklahoma
• Professional experience in direct patient care
• Demonstrated proficiency in computer skills, including Excel and clinical platforms
• Proven exemplary clinical documentation and critical thinking skills
• Designated secure workspace with high-speed internet access