Novitas Solutions, Inc. seeks a Clinical Review Nurse to review and substantiate medical determinations for health claims.
You will assess medical necessity, service levels, and appropriateness of care under national and local policies, including cases requiring prior authorization and complex reviews. The role emphasizes applying clinical knowledge to ensure accurate payment levels and compliance with accepted medical standards.
#J-18808-LjbffrClinical Review Nurse in workfromhome at Unknown Company
This position is listed as full time and onsite.