
This remote Clinical Reviewer Registered Nurse role involves evaluating service requests for adherence to clinical criteria and regulatory policies. The position requires issuing approvals or denials, identifying documentation needs, and communicating with healthcare providers and state workers. Key responsibilities also include mentoring junior reviewers and maintaining accurate records within contract systems. The role appeals to experienced nurses with a background in complex disabilities and Home and Community Based Services waivers who value the flexibility of working from a secure home office. The company provides necessary computer equipment, and the position offers a collaborative environment focused on improving patient care outcomes through thorough clinical review.












