Utilization Management Nurse Reviewer (LPN/RN)

Job Summary

A company is looking for a Quality Analyst (Remote, LPN/RN Required).

Key Responsibilities

• Conduct assessments of medical services to validate their appropriateness and ensure medical necessity
• Examine patient records to verify the quality of care and necessity of services provided
• Collaborate with healthcare providers and management teams to optimize patient care and maintain regulatory compliance

Required Qualifications

• Active and unrestricted LVN/RN license from an accredited program
• Minimum of 2 years clinical nursing experience
• At least 1 year of experience in Utilization Management
• Background in medical or clinical practice through education or professional engagement
• Proficiency in Microsoft tools such as Word, Excel, and Outlook