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Care Review Clinician

Location : Remote
Job Type : Contract
Reference Code : 15661
Hours : Full Time
Required Years of Experience : 5-7 years of Clinical Experience
Required Education : Bachelor Degree in Nursing
Travel : No
Relocation : No
Job Category : Healthcare - RNs & Nurse Management

Job Description :

Our client, a major healthcare system, is seeking a Care Review Clinician to assist their Utilization Management team!

Shift: 8:30a-5p Mon-Fri

Care Review Clinician Job Responsibilities:

  • Works with the UM team to review inpatient medical necessity while providing a high level of care.

  • Provides daily review and evaluation of patients’ that require hospitalization and/or procedures.

  • Completes prior authorizations and/or concurrent review.

  • Completes assigned work plan objectives and projects on a timely basis.


Care Review Clinician Job Requirements:

  • In depth knowledge of Interqual and other references for length of stay and medical necessity determinations.

  • MUST have experience using MCG Criteria.

  • Experience with NCQA

  • Must have and active unrestrictive CA RN License

  • 5-7 years of clinical practice in a hospital setting or utilization management/case management.


For immediate consideration, please email updated resume to

Required Qualifications :
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