Job Summary
A health insurance company is searching for a person to fill their position for a Remote Senior Nurse Reviewer in Sacramento.
Individual must be able to fulfill the following responsibilities:
- Conduct initial medical necessity clinical screening
- Conduct initial medical necessity review of exception preauthorization requests
- Follow-up to obtain additional clinical information as applicable
Position Requirements Include:
- Requires an AS/BS in nursing from an accredited institution
- 3 years of clinical nursing experience in an ambulatory or hospital setting
- 3 years of prior utilization, medical management and/or quality management and/or call center experience
- Current unrestricted RN license in applicable state(s) required
