Registered Nurse Clinical Reviewer

Job Summary

A company is looking for a Clinical Care Reviewer II - NICU.

Key Responsibilities

• Process medical necessity reviews for healthcare service authorization
• Coordinate care and facilitate timely discharge to appropriate levels of care
• Document and communicate with healthcare partners to ensure safe discharge planning

Required Qualifications, Training, and Education

• Completion of an accredited registered nursing (RN) degree program
• Minimum of three (3) years clinical NICU experience
• Utilization Management/Utilization Review experience preferred
• Medicaid/Medicare/Commercial experience preferred
• Current, unrestricted Registered Nurse (RN) Licensure in state(s) of practice required