The Clinical Nurse Reviewer plays a crucial role in evaluating and assessing medical records, progress notes, and healthcare Certificates of Medical Necessity to ensure compliance with industry standards, federal and state regulations, and quality of care.
Requirements
- College Degree in healthcare, nursing, or related fields.
- Minimum of 2 years’ experience working as a clinical nurse reviewer or in utilization management.
- Must have active LPN or RN Certification in the state in which they reside (must maintain certification).
- Ability to work collaboratively and independently and stay on task.
- Strong background knowledge in healthcare regulatory, government policy, and contracted payer policy.
- Excellent medical terminology skills.
- Excellent written and verbal communication skills.
Benefits
- Comprehensive medical, dental, and vision insurance plans
- Company sponsored wellness programs and mental health resources
- Paid leave of absence for qualifying events
- Generous paid parental leave for both birthing and non-birthing parents
- Competitive 401(k) plan with company match
- Financial planning services
- Corporate discount programs for goods and services
- Generous paid time off
- Flexible work hours
- Flexible work arrangement options
- Opportunities for continuous learning and career advancement
- Recognition programs
- Bonuses
- Awards
- Sustainability strategy
