State Licensed Legal Nurse

Job Summary

Evaluating medical necessity and appropriateness for claims, the full-time State Licensed Legal Nurse will review liability demand packages, analyze medical records, and support negotiation and litigation efforts in a remote environment.

Key responsibilities

• Evaluate liability demand packages, identifying gaps and cost drivers in medical records and treatment timelines
• Utilize evidence-based guidelines to determine authorization needs and escalate cases as necessary
• Document findings and write defensible nurse summaries for utilization review and demand review files

Required qualifications

• Associate or Bachelor's Degree in nursing
• Active RN license in one or more states
• Minimum 5 years of clinical, legal, utilization review, or case management experience
• Experience with liability demand packages and supporting claim litigation or negotiation
• Certifications such as CCMC, CLNC, CMAC, CRRN, CDMS, or COHN preferred