Job Summary
A company is looking for a Preservice Review Nurse - Behavioral Health - 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 individual and team performance metrics
- Engage in telephonic discussions with healthcare providers and members regarding benefit coverage determinations
Required Qualifications
- Current unrestricted RN license in the state of residency or compact state
- Professional experience in direct patient care
- Proven exemplary clinical documentation skills
- Demonstrated proficiency in computer skills, including Excel and Microsoft platforms
- Designated secure workspace with access to high-speed internet
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