Tennessee Licensed Senior Medical Reviewer

A company is looking for a Registered Nurse Senior Medical Reviewer (Medicare Part B).

Key Responsibilities

Lead and provide guidance to staff in specialty programs, medical review, and utilization management

Monitor workflow and assist in managing workloads and quality reviews

Ensure compliance with quality plans and participate in special projects as needed

Required Qualifications, Training, and Education

Active, unrestricted RN licensure in the United States or a compact multistate 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