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RN Care Review ClinicianVirtualVocations • Southport, Indiana, United States
RN Care Review Clinician

RN Care Review Clinician

VirtualVocations • Southport, Indiana, United States
8 days ago
Job type
  • Full-time
Job description
Providing clinical review support for Medicare inpatient utilization management activities, the full-time RN Care Review Clinician will conduct medical necessity reviews, partner with healthcare teams to ensure appropriate care delivery, and maintain regulatory compliance in a remote setting. Key responsibilities Assesses services for members to ensure optimal outcomes and compliance with regulations Analyzes clinical service requests against established clinical guidelines Collaborates with multidisciplinary teams to promote effective care delivery 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 effectively Proficiency in Microsoft Office suite and applicable software programs Strong organizational and critical-thinking skills
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RN Care Review Clinician • Southport, Indiana, United States

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