State Licensed Clinical Reviewer NurseVirtualVocations • Newark, Delaware, United States
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State Licensed Clinical Reviewer Nurse
VirtualVocations • Newark, Delaware, United States
[job_card.variable_days_ago]
[job_preview.job_type]
- [job_card.full_time]
[job_card.job_description]
A company is looking for a Surgery Clinical Reviewer, Nurse.
Key Responsibilities
Evaluate cases that do not pass the authorization approval process while promoting a supportive team approach
Review charts and analyze clinical documentation to approve services meeting clinical review criteria
Monitor quality of care standards in the provider network and document all communications with medical office staff
Required Qualifications
Current, unrestricted state licensure as a Registered Nurse
Associate or Bachelor's degree in Nursing
5+ years of clinical experience preferred
Not under current exclusion or sanction by any state or federal health care program
No history of disciplinary or legal action by a state medical board
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Clinical Reviewer • Newark, Delaware, United States
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