Tennessee Licensed Clinical Reviewer

Job Summary

A company is looking for a Clinical Reviewer, RN or LPN (Remote - TN).

Key Responsibilities

• Review requests for services including admission, discharges, and continued stays for adherence to clinical criteria and policies
• Issue approvals, denials, or recommendations based on contract requirements
• Complete documentation of activities within contract systems and communicate with providers and state workers as required

Required Qualifications

• High School Degree or equivalent required
• An active unrestricted RN or LPN license valid in Tennessee or a compact nursing license with Tennessee privileges
• Minimum of two years of clinical experience in an RN or LPN position
• Proficiency in Microsoft Office Suite and Adobe
• Strong clinical assessment and documentation skills