Texas Licensed Care Review Clinician

A company is looking for a Care Review Clinician I to work remotely in a contract position. Key Responsibilities Conduct concurrent reviews and prior authorizations for healthcare members Assess services to ensure compliance with regulations and optimal outcomes Collaborate with various departments to enhance continuity of care Required Qualifications Completion of an accredited Registered Nursing program or equivalent experience Minimum 0-2 years of clinical practice, preferably in hospital nursing or utilization management Active, unrestricted State Nursing (RN, LVN, LPN) license in good standing Experience with prior authorizations and/or behavioral health outpatient services Knowledge of state and federal regulations related to healthcare services

Jun 11, 2025 - 20:40

A company is looking for a Care Review Clinician I to work remotely in a contract position. Key Responsibilities Conduct concurrent reviews and prior authorizations for healthcare members Assess services to ensure compliance with regulations and optimal outcomes Collaborate with various departments to enhance continuity of care Required Qualifications Completion of an accredited Registered Nursing program or equivalent experience Minimum 0-2 years of clinical practice, preferably in hospital nursing or utilization management Active, unrestricted State Nursing (RN, LVN, LPN) license in good standing Experience with prior authorizations and/or behavioral health outpatient services Knowledge of state and federal regulations related to healthcare services