Registered Nurse Clinical Reviewer

Job Summary

A company is looking for a Clinical Reviewer, Nurse (Pain Management).

Key Responsibilities

• Evaluate cases that do not pass the authorization approval process, promoting a supportive team approach
• Review charts and analyze clinical record documentation to approve services meeting clinical review criteria
• Monitor quality of care standards and communicate with medical office staff regarding approvals and denials

Required Qualifications and Education

• Current, unrestricted state licensure as a Registered Nurse
• Associate or Bachelor's degree in Nursing
• Preferred experience as an RN in a Pain Management setting
• 5+ years of clinical experience is preferred
• No history of disciplinary or legal action by a state medical board