Pennsylvania Licensed Clinical Access RN

Job Summary

Working remotely in Pennsylvania, the full-time salaried Pennsylvania Licensed Clinical Access RN will perform utilization reviews, medical necessity assessments, and authorization activities to ensure quality outcomes and effective care transitions.

Key responsibilities

• Conduct utilization review and medical necessity assessments while collaborating with physicians and care teams
• Maintain accurate records of utilization reviews and ensure compliance with state, federal, and third-party payer standards
• Act as a resource for the healthcare team regarding third-party payer health plan benefits and documentation integrity

Required qualifications

• Current Pennsylvania RN license
• Minimum of three years of nursing experience
• Preferred experience in an acute care setting and utilization management
• Bachelor's degree in nursing (BSN) is preferred
• Graduate from a Specialty Training Program in Nursing