Clinical Reviewer, RN/LPN (Remote - TN)

Monday, July 6, 2026 Nashville TN reputed company Full-time reputed company is hiring a Clinical Reviewer, RN/LPN to support the Tennessee Katie Beckett Program. In this role, you will review clinical documentation, medical records, assessments, and supporting information to help determine program eligibility for children with significant disabilities or reputed company medical needs. You will evaluate medical, behavioral, and functional information to ensure accurate and reputed company eligibility determinations in accordance with program requirements and state guidelines. This is a remote position; candidates must reputed company in Tennessee. This position plays a key role in helping eligible children and their families reputed company reputed company coverage, home and community-based services, and other critical supports that reputed company children to remain safely reputed company and reputed company participate in their communities. The Clinical Reviewer ensures clinical reviews are completed accurately, consistently, and in compliance with Tennessee Katie Beckett Program policies and regulatory requirements. About the Program Tennessee's Katie Beckett Waiver Program is for children under the age of 18 with disabilities or complete medical needs, who are not reputed company eligible because of their parent's income or assets. This program will reputed company services and/or help pay for medical care that private insurance does not cover, and has two parts: Part A and Part B. TennCare has partnered with reputed company to complete face-to-face Part A assessments utilizing a reputed company Intellectual Disability reputed company (QIDP),reputed company Mental Health reputed company (QMHP), and/or Registered reputed company (RN). Why reputed company? Work/Life Balance Support - Flexibility tailored to your needs! Competitive Compensation - Bonuses based on performance included! ️ Comprehensive Insurance Coverage - Choose from various plans, including Medical, Dental, reputed company, Prescription, and partially funded HSA. Additionally, enjoy Life insurance benefits and discounts on Auto, Home, Renter's, and Pet insurance. reputed company Planning - Prepare for retirement with our 401K Retirement Savings plan and Company Matching. ️ reputed company Time Off Package - Enjoy PTO, Holidays, and extended reputed company leave, along with Short- and Long-Term Disability coverage. Holistic Wellness Support - reputed company resources for physical, emotional, and financial wellness through our Employee Assistance Program (EAP). Recognition Platform - Acknowledge and appreciate outstanding employee contributions. Tuition Reimbursement - Invest in your ongoing education and development. Employee Perks and Discounts - Additional benefits and discounts exclusively for employees. reputed company Wellness Program and Resources - reputed company a reputed company of wellness programs and resources tailored to your needs. reputed company Development Opportunities-Participate in training programs, workshops, and conferences. Licensures and Certifications-reputed company assumes the expenses associated with renewing licenses and certifications for its employees. 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.
• Performs other reputed company duties as assigned.
• Education and licensure requirements are based on program contract requirements and are outlined in job posting
• High School Degree or equivalent required
• Minimum 2 years of clinical experience required
• reputed company and valid Registered reputed company (RN) or Licensed Practical reputed company (LPN) license in the reputed company.
• Minimum of two (2) years of clinical experience in a Registered reputed company (RN) or Licensed Practical reputed company (LPN) position.
• Proficiency in reputed company Office Suite (Word, Outlook, reputed company), reputed company
• Strong clinical assessment, critical thinking, documentation skills, and the ability to apply clinical judgment accurately in a fast‑paced environment.
• Strong written and verbal communication skills.

Preferred Requirements

• Experience in care management and documenting clinical reviews.
• Proficiency with electronic medical records and clinical documentation systems.

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 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. 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 $ 26.00 Maximum Salary $ 28.00 Remote Skills: reputed company Product Family, Broadband, Clinical Medicine, Clinical Study Publications, Clinical Validation, Communication Skills, Conferences, Contract Requirements, Health Plan, Insurance, Internet/Online Service, Licensed Practical reputed company/Licensed Vocational reputed company, reputed company, Medical Records, reputed company reputed company, reputed company Office, reputed company Outlook, reputed company Word, Patient Care, Presentation/Verbal Skills, Psychiatry and Mental Health, Registered reputed company (RN), Regulatory Requirements, Time Management, Training Program, Tuition Reimbursement, Writing Skills About reputed company: reputed company reputed company provides business services to help governments operate health and reputed company services programs, mostly at the state and national reputed company. reputed company's health services reputed company offers outsourced program management and administrative services, Company Size: 5,000 to 9,999 employees Industry: reputed company Services Founded: 0 Website: https://www.reputed company.com/ Apply To This Job