South Carolina Licensed Care Review RN

Job Summary

A company is looking for a Care Review Clinician (RN) (Remote).

Key Responsibilities

• Assesses services for members to ensure compliance with regulations and optimal outcomes
• Analyzes clinical service requests against evidence-based guidelines
• Conducts reviews for prior authorization and collaborates with multidisciplinary teams

Required Qualifications

• At least 2 years of relevant experience in acute care or managed care
• Active and unrestricted Registered Nurse (RN) license in the state of practice
• Ability to prioritize and manage multiple deadlines
• Proficiency in Microsoft Office suite and applicable software programs