California Licensed RN Reviewer

To support a growing healthcare organization, the full-time remote California Licensed RN Reviewer will conduct clinical reviews of enrollment documentation, ensuring accurate and compliant enrollment determinations for prospective participants. Key responsibilities Conduct clinical reviews of Level of Care assessments and enrollment documentation to evaluate participant readiness Utilize organizational guidelines and state-specific regulatory requirements to drive consistent enrollment recommendations Document review findings and communicate with stakeholders regarding participant readiness and documentation gaps Required qualifications Active, unrestricted Registered Nurse (RN) license in good standing Minimum of three (3) years of PACE experience Experience in managed care, utilization review, or regulatory healthcare Demonstrated ability to review clinical documentation and conduct clinical assessments Proficiency in using Excel, Word, and electronic health records