State Licensed Clinical Reviewer Nurse

Job Summary

A company is looking for a Clinical Reviewer, Nurse.

Key Responsibilities

• Evaluate cases that do not pass the authorization approval process and promote a supportive team approach
• Review charts and analyze clinical documentation to approve services meeting clinical review criteria
• Monitor quality of care standards and communicate with medical office staff regarding approvals and denials

Required Qualifications

• Current, unrestricted state licensure as a Registered Nurse
• Associate or Bachelor's degree in Nursing
• Ability to work a minimum of 30 hours per week
• 5+ years of clinical experience (preferred)
• Proficient computer skills, including the ability to talk and type simultaneously