Registered Nurses
About this role
Registered Nurses
- Category : Healthcare
- Employment type : Contract
- Reference : BH-400348
Registered needed for a REMOTE contract opportunity with Yoh’s insurance client located in Philadelphia, PA. This candidate reviews medical records to assess members' clinical conditions and determine medical necessity for services using independent judgment and established criteria. They obtain additional clinical information from providers as needed, approve medically necessary services, escalate non-qualifying cases to the Medical Director, ensure regulatory compliance, and serve as a patient advocate and resource for navigating the healthcare system.
Candidate must reside in the tri-state area (PA, DE, NJ) Candidate must have an active PA license or a Nurse Licensure Compact to include PA
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