Registered Nurse 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 clinical documentation to approve services meeting review criteria
• Monitor quality of care standards and communicate approvals/denials to medical office staff

Required Qualifications

• Current, unrestricted state licensure as a Registered Nurse
• Associate or Bachelor's degree in Nursing
• Preferred experience as an RN in a Pain Management setting
• Minimum of 5 years clinical experience preferred
• No history of exclusion or sanction by state or federal health care programs