Registered Nurse Clinical Reviewer

A company is looking for a Clinical Care Reviewer II - Post Acute. Key Responsibilities Process medical necessity reviews for healthcare service authorizations Coordinate care and facilitate timely discharge planning for members Refer cases to Medical Directors when clinical criteria are not met Required Qualifications, Training, and Education Completion of an accredited registered nursing (RN) degree program Minimum of three (3) years of clinical experience Preferred experience in med / surgical, emergency acute care, or home health Utilization Management / Utilization Review experience is preferred Current, unrestricted Registered Nurse (RN) Licensure in state(s) of practice