A company is looking for a Care Review Clinician (RN).
Key Responsibilities
Assess services for members to ensure optimum outcomes and compliance with regulations
Analyze clinical service requests against evidence-based clinical guidelines
Conduct reviews for prior authorization and collaborate with multidisciplinary teams
Required Qualifications
At least 2 years of experience in hospital acute care 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 or applicable software programs
Licensed Clinician • Orange, California, United States