California Licensed Care Review Clinician
A company is looking for a Care Review Clinician II (RN or LVN) Remote. Key Responsibilities: Perform clinical reviews of service requests including concurrent and prior authorization determinations Serve as clinical support to the Continuity of Care (COC) and Community Support teams Utilize InterQual and other clinical guidelines to assess medical necessity and appropriate length of stay Required Qualifications: Active, unrestricted LVN or RN license in California 3-5 years of clinical experience (inpatient, outpatient, or hospital setting strongly preferred) Prior experience in Utilization Management, Concurrent Review, or Prior Authorization Solid computer proficiency, including ability to toggle between multiple databases and tools Experience using InterQual or similar medical necessity criteria tools
A company is looking for a Care Review Clinician II (RN or LVN) Remote.
Key Responsibilities:
Perform clinical reviews of service requests including concurrent and prior authorization determinations
Serve as clinical support to the Continuity of Care (COC) and Community Support teams
Utilize InterQual and other clinical guidelines to assess medical necessity and appropriate length of stay
Required Qualifications:
Active, unrestricted LVN or RN license in California
3-5 years of clinical experience (inpatient, outpatient, or hospital setting strongly preferred)
Prior experience in Utilization Management, Concurrent Review, or Prior Authorization
Solid computer proficiency, including ability to toggle between multiple databases and tools
Experience using InterQual or similar medical necessity criteria tools
