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Nurse Reviewer - Home Health
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- Nurse Reviewer- Home Health (Nurse Reviewer I)
- A proud member of the Elevance Health family of companies, Carelon Post Acute Solutions, formerly myNEXUS, is the leader in health resource optimization, focused on transforming how healthcare is delivered and promoting the advancement of care for the people we serve.
- The Nurse Reviewer I is responsible for conducting preauthorization, out of network and appropriateness of treatment reviews for home health services by utilizing appropriate policies, clinical and department guidelines.
- Collaborates with healthcare providers, and members to promote the most appropriate, highest quality and effective use of diagnostic imaging to ensure quality member outcomes, and to optimize member benefits.
- Through work experience and mentoring learns to conduct medical necessity clinical screenings of preauthorization request to assess assessing the medical necessity of diagnostic imaging procedures, out of network services, and appropriateness of treatment.
Expired 11 days agoInactive Job
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