Texas Licensed Care Review Clinician

Job Summary

A company is looking for a Care Review Clinician I to work remotely in a contract position.

Key Responsibilities

• Conduct concurrent reviews and prior authorizations for healthcare members
• Assess services to ensure compliance with regulations and optimal outcomes
• Collaborate with various departments to enhance continuity of care

Required Qualifications

• Completion of an accredited Registered Nursing program or equivalent experience
• Minimum 0-2 years of clinical practice, preferably in hospital nursing or utilization management
• Active, unrestricted State Nursing (RN, LVN, LPN) license in good standing
• Experience with prior authorizations and/or behavioral health outpatient services
• Knowledge of state and federal regulations related to healthcare services