Clinical Review Registered Nurse
2 days ago
Blue Cross and Blue Shield of Vermont is seeking a skilled Clinical Review Registered Nurse to join our Utilization Management team. As a key member of our team, you will play a critical role in ensuring the delivery of high-quality, cost-effective care to our members.
Key Responsibilities:
- Conduct thorough clinical reviews to determine medical necessity and appropriateness of services.
- Identify and address potential issues or concerns through collaboration with medical directors and other stakeholders.
- Develop and maintain expertise in clinical review processes and guidelines.
Requirements:
- RN with Vermont license required; BSN desired.
- 5-7 years of clinical practice experience.
- 1-3 years of insurance-related experience desired.
- Ability to participate in ongoing CEU training.
Benefits:
- Competitive salary and comprehensive benefits package.
- Opportunities for professional growth and development.
- Flexible work arrangements, including remote work options.
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Clinical Review Registered Nurse Position
2 weeks ago
Montpelier, Vermont, United States BlueCross BlueShield of Vermont Full timeJob Title: Clinical Review Registered NurseWe are seeking a skilled Clinical Review Registered Nurse to join our Utilization Management team at Blue Cross and Blue Shield of Vermont. As a key member of our team, you will play a critical role in ensuring the delivery of high-quality, cost-effective care through the performance of clinical...
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Clinical Review Registered Nurse Position
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Montpelier, Vermont, United States BlueCross BlueShield of Vermont Full timeJob Title: Clinical Review Registered NurseWe are seeking a skilled Clinical Review Registered Nurse to join our Utilization Management team at Blue Cross and Blue Shield of Vermont. As a key member of our team, you will play a critical role in ensuring the delivery of high-quality, cost-effective care through the performance of clinical...
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