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Virginia Licensed Care Review Clinician
A company is looking for a Care Review Clinician I. Key Responsibilities Conducts concurrent reviews and prior authorizations for Client members Identifies benefits, eligibility, and expected length of stay for treatment requests Participates in interdepartmental collaboration 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 outpatient care, particularly DME and therapy Familiarity with state and federal regulations related to healthcare services
A company is looking for a Care Review Clinician I.
Key Responsibilities
Conducts concurrent reviews and prior authorizations for Client members
Identifies benefits, eligibility, and expected length of stay for treatment requests
Participates in interdepartmental collaboration 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 outpatient care, particularly DME and therapy
Familiarity with state and federal regulations related to healthcare services