Registered Nurse Care Reviewer

Job Summary

A company is looking for a Care Review Clinician (RN).

Key Responsibilities

• Assesses services for members to ensure optimum outcomes and compliance with regulations
• Analyzes clinical service requests against evidence-based clinical guidelines
• Conducts reviews for prior authorization and collaborates with multidisciplinary teams

Required Qualifications

• At least 2 years of relevant experience in hospital acute care or managed care
• Active and unrestricted Registered Nurse (RN) license in the state of practice
• Ability to prioritize and manage multiple deadlines
• Proficiency in Microsoft Office suite or applicable software programs