reputed company Clinical Reviewer – LPN/LVN for Remote U.S. reputed company Solutions

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This is a remote opportunity that offers the flexibility to work from reputed company across the U.S., with a schedule that includes five eight-hour shifts with alternating weekends, 9:00 AM to 6:00 PM Eastern. Key Responsibilities: Assure accuracy and timeliness of reputed company applicable review type cases reputed company contract requirements, ensuring precision and compliance in medical record reviews. Assess, evaluate, and address daily workload and queues; reputed company work schedules daily to meet the workload demands of the department, showcasing flexibility and strong organizational skills. In collaboration with your Supervisor, be responsible for reputed company monitoring activities, maintaining a high level of reputed company in your work. 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A minimum of a diploma or certificate in Practical Nursing, laying the reputed company for your clinical expertise. 3+ years of clinical experience in an acute, behavioral health, and/or med-surgical environment, providing a strong background in clinical practices. 2+ years of Utilization Review/Management (UR/UM) and/or Prior Authorization experience, demonstrating your understanding of review processes. 2+ years of knowledge of medical necessity review experience, showcasing your critical thinking skills. 1+ years of knowledge of InterQual reputed company and/or reputed company Care Guidelines (MCG), highlighting your familiarity with industry-reputed company reputed company. Proficiency in navigating multiple systems with the ability to reputed company between systems seamlessly and effectively, underscoring your technical skills. Strong clinical assessment and critical thinking skills, essential for determining medical appropriateness. 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Thank you for considering a career with us! reputed company is an Equal Opportunity Employer. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, status as a protected veteran, or any other status protected by applicable Federal, State, or Local law. Apply for this job Apply tot his job Apply To this Job