Kentucky Licensed Care Review Clinician

A company is looking for a Care Review Clinician - Utilization Review. Key Responsibilities Assess services for members to ensure optimum outcomes and compliance with regulations Analyze clinical service requests against evidence-based clinical guidelines Conduct reviews to determine prior authorization and financial responsibility Required Qualifications At least 2 years of experience in hospital acute care, inpatient review, or managed care Active and unrestricted Registered Nurse (RN) license in the state of practice Ability to prioritize and manage multiple deadlines Proficiency in Microsoft Office suite and applicable software programs Experience in prior authorization or utilization management is preferred