Registered Nurse RN Clinical Reviewer

Job Summary

A company is looking for a Registered Nurse (RN) to fill a Clinical Reviewer position.

Key Responsibilities:

• Review requests for services including admission, discharges, and continued stays for adherence to clinical criteria, state and federal policy, and related requirements
• Issue approvals, denials, or recommendations based on contract requirements
• Identify the need for additional clinical documentation or consultation

Required Qualifications:

• Associate's degree required
• Active, unrestricted RN licensure required
• Minimum 3 years of mental health experience required
• Minimum 3 years of long-term care experience required
• PASRR screening experience preferred