Jobtailor is seeking an experienced registered nurse to assess medical necessity and conduct utilization management reviews. You will perform pre-certification, concurrent, and retrospective reviews to ensure services meet clinical guidelines and patient needs.
The role requires NC RN license, 5+ years of nursing experience or BSN with 3 years, and familiarity with diagnostic treatment guidelines and level of care criteria.
#J-18808-LjbffrRN Clinical Specialist — Medical Necessity & Utilization in morrisville at Unknown Company
This position is listed as full time and onsite.