RN Clinical Review Coordinator

A company is looking for an RN, Clinical Review Coordinator - Remote MST or PST. Key Responsibilities Research member benefits and eligibility, and complete assigned cases within required timeframes Prepare and document clinical case reviews, communicating determinations to providers and members Collaborate with internal stakeholders to ensure appropriate levels of care and maintain continuity of care Required Qualifications Current unrestricted RN license in state of residence 5+ years of clinical experience 3+ years of experience in Case Management, UM preferred 1+ years working in managed care or in the insurance industry Experience with Medicare and/or Medicaid

Feb 28, 2025 - 21:26

A company is looking for an RN, Clinical Review Coordinator - Remote MST or PST. Key Responsibilities Research member benefits and eligibility, and complete assigned cases within required timeframes Prepare and document clinical case reviews, communicating determinations to providers and members Collaborate with internal stakeholders to ensure appropriate levels of care and maintain continuity of care Required Qualifications Current unrestricted RN license in state of residence 5+ years of clinical experience 3+ years of experience in Case Management, UM preferred 1+ years working in managed care or in the insurance industry Experience with Medicare and/or Medicaid