Tennessee Licensed Clinical Reviewer

Job Summary

Supporting the Tennessee Katie Beckett Program, the full-time Tennessee Licensed Clinical Reviewer will review clinical documentation and medical records to determine eligibility for children with significant disabilities or complex medical needs, all while working remotely from Tennessee.

Key responsibilities

• Review requests for services to ensure adherence to clinical criteria and state and federal policies
• Issue approvals, denials, or recommendations based on contract requirements
• Communicate with providers and state workers as necessary to facilitate the review process

Required qualifications

• Current and valid Registered Nurse (RN) or Licensed Practical Nurse (LPN) license in Tennessee
• Minimum of two years of clinical experience in an RN or LPN position
• High School Degree or equivalent required
• Proficiency in Microsoft Office Suite and Adobe
• Strong clinical assessment and documentation skills