Tennessee Licensed Clinical Reviewer

Job Summary

Supporting the Tennessee Katie Beckett Program, the full-time remote Tennessee Licensed Clinical Reviewer will evaluate clinical documentation and medical records to determine eligibility for children with significant disabilities or complex medical needs.

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, individuals, and state workers as needed while documenting activities within contract systems

Required qualifications

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