Utah Licensed Care Review RN

A company is looking for a Care Review Clinician (RN).

Key Responsibilities

Assesses services for members to ensure optimum outcomes and compliance with regulations

Analyzes clinical service requests against evidence-based clinical guidelines

Conducts reviews to determine prior authorization and financial responsibility

Required Qualifications

At least 2 years of experience in hospital acute care, inpatient review, or managed care

Active and unrestricted Registered Nurse (RN) license in the state of practice

Ability to prioritize and manage multiple deadlines

Proficiency in Microsoft Office suite and applicable software programs