Remote Clinical Review RN

Job Summary

A company is looking for a Clinical Claim Review RN - Remote.

Key Responsibilities:

• Review and interpret clinical documentation to determine medical appropriateness
• Make determinations based on relevant protocols and clinical judgment
• Summarize clinical information and provide medical recommendations to medical directors

Required Qualifications:

• Current unrestricted RN licensure in state of residence
• MCG certification, or willingness to obtain within 2 years of hire
• 5+ years of RN experience
• 2+ years of RN experience in an acute care facility