Registered Nurse Clinical Reviewer

A company is looking for a Clinical Care Reviewer II with a BH UM background. Key Responsibilities Process medical necessity reviews for healthcare service authorizations Coordinate care and facilitate timely discharge planning Refer cases to medical directors when clinical criteria are not met Required Qualifications, Training, and Education Completion of an accredited registered nursing (RN) degree program Minimum of three (3) years of clinical experience Preferred experience in med/surgical, emergency acute care, or home health Preferred medical management experience Current, unrestricted RN licensure in state(s) of practice

Apr 1, 2025 - 12:28

A company is looking for a Clinical Care Reviewer II with a BH UM background. Key Responsibilities Process medical necessity reviews for healthcare service authorizations Coordinate care and facilitate timely discharge planning Refer cases to medical directors when clinical criteria are not met Required Qualifications, Training, and Education Completion of an accredited registered nursing (RN) degree program Minimum of three (3) years of clinical experience Preferred experience in med/surgical, emergency acute care, or home health Preferred medical management experience Current, unrestricted RN licensure in state(s) of practice