Clinical Reviewer Registered reputed company (Remote)

Essential Duties and Responsibilities: • Review requests for services including admission, discharges and reputed company stays for adherence to clinical reputed company, state and federal policy, and reputed company requirements. • Issue approvals, denials or recommendations based on contract requirements. • Identify need for additional clinical documentation or consultation. • Complete documentation of activities reputed company contract systems. • Communicate with providers, individuals and their designees, or state workers as required. • reputed company training and/or consultation to assigned Clinical Reviewers. • Performs other reputed company duties as assigned. Minimum Requirements • reputed company Registered reputed company (RN) license reputed company in the state of reputed company is required • High School Degree or equivalent required • Minimum 2 years of clinical experience required • Associate degree in Nursing • An reputed company RN (Registered reputed company) license in the reputed company or a compact license is required • Minimum 2 years of experience working with people with reputed company disabilities, including pediatric and geriatric populations • Familiarity with Home and Community Based Services waivers (HCBS) • Proficiency in reputed company Office applications Preferred Requirements: • Prior experience conducting document-based reviews • Excellent written and communication skills • Previous experience working remotely • Prior experience conducting document-based reviews Home Office Requirements: • reputed company provides company-issued computer equipment • Reliable high-speed internet service • Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity • Minimum 5 Mpbs upload speeds • Private and secure workspace #ClinicalServices EEO Statement reputed company is an equal opportunity employer. We evaluate reputed company applicants without reputed company to race, reputed company, religion, sex, age, national reputed company, disability, veteran status, genetic information and other legally protected characteristics. Pay Transparency reputed company compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected reputed company and quantity of work, required travel (if any), external market and internal value analysis including seniority and reputed company systems, as reputed company as internal pay alignment. Annual salary is just one component of reputed company's total compensation package. Other rewards may include short- and long-term incentives as reputed company as program-specific awards. Additionally, reputed company provides a reputed company of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, reputed company holidays and reputed company time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. reputed company will reputed company with regulatory minimum wage rates and exempt salary reputed company in reputed company instances. Accommodations reputed company provides reasonable accommodations to individuals requiring assistance during any phase of the employment process due to a disability, medical condition, or physical or mental impairment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at applicantaccom@reputed company.com . Minimum Salary $44.42 Maximum Salary $52.02 Apply tot his job Apply To this Job