California Licensed Clinical Reviewer

Job Summary

A company is looking for a Clinical Reviewer, Nurse.

Key Responsibilities

• Evaluate cases that do not pass the authorization approval process and support team collaboration
• Review charts and analyze clinical documentation to approve services meeting review criteria
• Monitor quality of care standards and communicate with medical office staff regarding approvals and denials

Required Qualifications, Training, and Education

• Current, unrestricted state licensure as a Registered Nurse
• California or Oregon License required
• Associate or Bachelor's degree in Nursing
• Minimum of 30 hours/week availability
• 5+ years of clinical experience preferred