Ohio Licensed Clinical Care Reviewer

A company is looking for a Clinical Care Reviewer II. Key Responsibilities Process medical necessity reviews for various healthcare services and coordinate care for timely discharge planning Refer cases to Medical Directors when clinical criteria are not met and maintain knowledge of relevant regulations and standards Document and communicate with healthcare partners to ensure safe discharge planning and care coordination Required Qualifications Completion of an accredited registered nursing (RN) degree program Minimum of three (3) years of clinical experience Preferred experience in med/surgical, emergency acute clinical care, or home health Utilization Management/Utilization Review experience is preferred Current, unrestricted Registered Nurse (RN) Licensure in state(s) of practice is required

Jun 12, 2025 - 20:50

A company is looking for a Clinical Care Reviewer II. Key Responsibilities Process medical necessity reviews for various healthcare services and coordinate care for timely discharge planning Refer cases to Medical Directors when clinical criteria are not met and maintain knowledge of relevant regulations and standards Document and communicate with healthcare partners to ensure safe discharge planning and care coordination Required Qualifications Completion of an accredited registered nursing (RN) degree program Minimum of three (3) years of clinical experience Preferred experience in med/surgical, emergency acute clinical care, or home health Utilization Management/Utilization Review experience is preferred Current, unrestricted Registered Nurse (RN) Licensure in state(s) of practice is required