Pennsylvania Licensed Medical Review Nurse

A company is looking for a Medical Review Nurse. Key Responsibilities of the Medical Review Nurse: Conduct prospective, concurrent, and retrospective reviews for various medical services Evaluate medical necessity of services and refer cases to the Medical Director as needed Document case activities and collaborate with stakeholders for timely case progression Qualifications and Skills for the Medical Review Nurse: Active, unrestricted RN license (PA or Compact state license preferred) Minimum three years of clinical nursing experience Ability to independently research international medical care standards Familiarity with U.S. managed care systems and experience in international care preferred Reliable internet connection (minimum 75 Mbps)

Apr 3, 2025 - 16:34

A company is looking for a Medical Review Nurse. Key Responsibilities of the Medical Review Nurse: Conduct prospective, concurrent, and retrospective reviews for various medical services Evaluate medical necessity of services and refer cases to the Medical Director as needed Document case activities and collaborate with stakeholders for timely case progression Qualifications and Skills for the Medical Review Nurse: Active, unrestricted RN license (PA or Compact state license preferred) Minimum three years of clinical nursing experience Ability to independently research international medical care standards Familiarity with U.S. managed care systems and experience in international care preferred Reliable internet connection (minimum 75 Mbps)