Registered Nurse Clinical Reviewer

Job Summary

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

Key Responsibilities

• Conduct medical necessity reviews for post-acute health care services
• Assist with discharge planning activities and care coordination for members
• Document member discharge planning needs and communicate with stakeholders

Required Qualifications, Training, and Education

• Completion of an accredited registered nursing (RN) degree program
• Minimum of three (3) years clinical experience
• Preferred experience in med/surgical, emergency, acute clinical care, or post-acute care
• Utilization Management/Utilization Review experience preferred
• Current, unrestricted Registered Nurse (RN) Licensure in state(s) of practice required