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Care Review Clinician ll

Location : San Antonio, TX
Job Type : Contract to Direct
Reference Code : 12918
Hours : Full Time
Required Years of Experience : 2
Travel : No
Relocation : No
Job Industry : Healthcare - Health Services
Job Category : Healthcare - RNs & Nurse Management

Job Description :

We are looking for a RN/LVN Care Review Clinician I in the state of Texas. For these positions you must have an active, unrestricted TX or compact license to qualify for these positions. These are full time remote positions and you must also be able to cover a Saturday or Sunday each week once trained and independent.

Job Duties: Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members with the right care at the right place at the right time. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for Members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines.

Required Experience: Minimum 2 years of clinical experience required. Preferably hospital nursing Utilization Management experience is a plus.
Required Licensure/Certification: Active, unrestricted State Nursing RN/LVN license in good standing.


For immediate consideration please email

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