State Licensed Clinical Care Reviewer

A company is looking for a Clinical Care Reviewer II - UM Marketplace. Key Responsibilities Process medical necessity reviews for healthcare service authorizations and assist with discharge planning activities Coordinate care and facilitate timely and cost-effective discharge to appropriate levels of care Document and communicate with Health Partners, Care Managers, and Discharge Planners to ensure safe discharge planning and care coordination Required Qualifications, Training, and Education Completion of an accredited registered nursing (RN) degree program is required Minimum of three (3) years of clinical experience is required 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 10, 2025 - 03:00

A company is looking for a Clinical Care Reviewer II - UM Marketplace. Key Responsibilities Process medical necessity reviews for healthcare service authorizations and assist with discharge planning activities Coordinate care and facilitate timely and cost-effective discharge to appropriate levels of care Document and communicate with Health Partners, Care Managers, and Discharge Planners to ensure safe discharge planning and care coordination Required Qualifications, Training, and Education Completion of an accredited registered nursing (RN) degree program is required Minimum of three (3) years of clinical experience is required 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