Tennessee Licensed Senior Medical Reviewer

A company is looking for a Registered Nurse Senior Medical Reviewer (Home Health and Hospice).

Key Responsibilities

Acts as team leader for medical review and case management, providing guidance and training to staff

Monitors workflow and workloads, ensuring timely completion of tasks and addressing any issues

Participates in quality reviews and compliance initiatives, ensuring adherence to quality plans

Required Qualifications, Training, and Education

Active, unrestricted RN licensure in the state of hire or compact multistate RN license

Associate Degree in Nursing or graduation from an accredited school of nursing

Four years of clinical experience or a combination of clinical and medical review experience totaling four years

Working knowledge of managed care and healthcare delivery systems

Proficiency in Microsoft Office software