Virginia Licensed RN Clinical Reviewer

Job Summary

A company is looking for a RN Clinical Reviewer to join their team.

Key Responsibilities

• Review medical records for accuracy and compliance with contract requirements
• Manage daily workload and adjust schedules to meet departmental demands
• Monitor quality and implement improvement plans in collaboration with supervisors

Required Qualifications

• Licensed Practical Nurse (LPN) or Registered Nurse (RN) license for the State of Virginia or compact license
• For LPN: Associate's degree or practical nursing diploma; for RN: Bachelor's degree in a related field
• 1+ year of experience in Prior Authorization, Utilization Review, or Utilization Management
• Ability to work alternating weekends