State Licensed Clinical Reviewer

Job Summary

A company is looking for a Clinical Reviewer, Nurse Practitioner/Physician Assistant (Vascular Surgery).

Key Responsibilities

• Act as a clinical liaison to providers, clients, and patients regarding medical necessity decisions
• Maintain and operate the Guideline Directed Medical Therapy, communicating recommendations to offices
• Coordinate with utilization management staff to ensure timely and accurate communication of clinical decisions

Required Qualifications, Training, and Education

• Master of Science in Nursing or Doctor of Nursing Practice (DNP) degree, or a master's degree from an accredited ARC-PA program
• Minimum of five years' experience in Vascular Surgery or primary care, with at least two years in a regulatory role preferred
• Current, unrestricted state PA or RN/NP license in medicine or required specialty
• Passing score on a national certifying exam for PAs
• Ability to obtain and maintain required licenses in states where the company operates