Tennessee Licensed Senior Medical Reviewer

Job Summary

A company is looking for a Registered Nurse Senior Medical Reviewer (Home Health and Hospice).

Key Responsibilities

• Acts as team leader for medical review and case management, providing guidance and training to staff
• Monitors workflow and workloads, ensuring timely completion of tasks and addressing any issues
• Participates in quality reviews and compliance initiatives, ensuring adherence to quality plans

Required Qualifications, Training, and Education

• Active, unrestricted RN licensure in the state of hire or compact multistate RN license
• Associate Degree in Nursing or graduation from an accredited school of nursing
• Four years of clinical experience or a combination of clinical and medical review experience totaling four years
• Working knowledge of managed care and healthcare delivery systems
• Proficiency in Microsoft Office software