RN Clinical Reviewer

Job Summary

A company is looking for a remote RN Clinical Reviewer to support its growing team.

Key Responsibilities

• Participate in a multi-disciplinary team to enhance healthcare quality for individuals and populations
• Apply clinical criteria and guidelines to assess the medical necessity of healthcare services
• Consult with physicians or refer cases as necessary

Required Qualifications

• A degree or diploma in nursing
• Current, active, unrestricted RN licensure in good standing
• 3 years of clinical work experience, including critical care, emergency department, and/or intensive care
• 1+ years of utilization review or medical management experience is preferred