Job Summary
A healthcare insurance company needs applicants for an opening for a Remote Associate or Level 1 Registered Nurse Reviewer in Sacramento.
Candidates will be responsible for the following:
- Conducting initial medical necessity clinical screening
- Determining if initial clinical information presented meets medical necessity criteria
- Receiving pre-authorization requests from front-line intake
Qualifications for this position include:
- Knowledge of managed healthcare programs
- Current active, valid, unrestricted RN license
- Develops telephone service standards to meet departmental performance metrics