RN Long Term Services Reviewer

A company is looking for a Long Term Services & Support Reviewer Utilization Management, RN. Key Responsibilities Complete care and service needs reviews for Long Term Services and Supports (LTSS) Evaluate authorization requests and apply medical health benefit policy to ensure appropriate services are approved Document case activities and maintain compliance with authorization timeliness standards Required Qualifications Bachelor's Degree required Professional licensure in health care or social services-related field preferred Registered Nurse is preferred Three or more years of experience in a related clinical or social services setting Expertise in addressing the needs of the Long Term Services and Support population

Mar 5, 2025 - 13:55

A company is looking for a Long Term Services & Support Reviewer Utilization Management, RN. Key Responsibilities Complete care and service needs reviews for Long Term Services and Supports (LTSS) Evaluate authorization requests and apply medical health benefit policy to ensure appropriate services are approved Document case activities and maintain compliance with authorization timeliness standards Required Qualifications Bachelor's Degree required Professional licensure in health care or social services-related field preferred Registered Nurse is preferred Three or more years of experience in a related clinical or social services setting Expertise in addressing the needs of the Long Term Services and Support population