Job Summary
A company is looking for a Preservice Review Nurse RN - Remote.
Key Responsibilities
- Perform clinical coverage review services, interpreting state and federal mandates and relevant clinical information
- Collaborate with a self-directed team to meet performance metrics and communicate benefit determinations
- Engage in telephonic discussions with healthcare providers and members regarding coverage determinations and clinical information
Required Qualifications
- Current unrestricted RN license in the state of residency
- Professional experience in direct patient care
- Demonstrated proficiency in computer skills including Excel and clinical platforms
- Designated secure workspace with access to high-speed internet
- Flexible with work hours, including a weekend rotation schedule
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