South Carolina Licensed RN Medical Reviewer

Acting as a team leader for specialty programs, the full-time South Carolina Licensed RN Medical Reviewer will provide guidance and training to staff in medical review, utilization management, and case management while working remotely with occasional on-site requirements for training and meetings. Key responsibilities Lead and mentor staff in medical review processes and ensure adherence to quality standards Monitor workflow and workloads, reallocating tasks as necessary to meet deadlines Engage in departmental quality reviews and oversee compliance initiatives and special projects Required qualifications Associate's degree in a job-related field or graduate of an accredited School of Nursing Four years of clinical experience, or a combination of two years clinical and two years medical review/utilization review experience Active, unrestricted RN licensure in South Carolina or a compact multistate RN license Strong clinical experience in home health, rehabilitation, or broad medical-surgical settings Proficiency in Microsoft Office applications