Clinical Review Nurse
Company: VirtualVocations
Location: Sugar Land
Posted on: April 6, 2025
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Job Description:
A company is looking for a Clinical Review Nurse -
Correspondence.
Key Responsibilities
Drafts correspondence letters based on clinical review outcomes in
compliance with NCQA standards
Investigates denials and creates/edit denial letters while
collaborating with the correspondence team
Coordinates with interdepartmental teams to identify training needs
and provides feedback for process improvements
Required Qualifications
Graduate from an Accredited School of Nursing or Bachelor's degree
in Nursing
2 - 4 years of related experience
Knowledge of Medicare and Medicaid regulations preferred
Knowledge of utilization management processes preferred
Ability to comply with all policies and standards
Keywords: VirtualVocations, Sugar Land , Clinical Review Nurse, Healthcare , Sugar Land, Texas
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