State Licensed Med Surg Nurse
A company is looking for a Med Surg Nurse / Psych Nurse. Key Responsibilities Analyze written appeals and draft detailed response letters addressing complex issues Prepare appeal cases for physician review and communicate final decisions to members and providers Utilize clinical judgment to assess adverse decisions and ensure compliance with regulations Required Qualifications High School Diploma or equivalent 2 years of clinical experience in a medical-surgical or similar setting or 3 years in mental health or psychiatric care Active RN license (state or compact) BSN or MSN degree preferred Experience in Medical Review, Utilization Management, or Case Management preferred
