Massachusetts Licensed RN Reviewer
Company: VirtualVocations
Location: Philadelphia
Posted on: February 5, 2025
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Job Description:
A company is looking for an RN Utilization Management
Reviewer.
Key Responsibilities:
Conducts timely clinical decision reviews for services requiring
prior authorization across various clinical areas
Applies established criteria and clinical expertise to determine
medical necessity of services
Communicates review results and provides decision-making guidance
to clinical teams
Required Qualifications:
RN - Associate's Degree required, Bachelor's Degree preferred
Current RN license issued by the Massachusetts Board of
Registration in Nursing
1 to 2 years of Utilization Management experience
2 or more years working in a clinical setting
CCM (Certified Case Manager) certification is a plus
Keywords: VirtualVocations, Mount Vernon , Massachusetts Licensed RN Reviewer, Healthcare , Philadelphia, New York
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