Provide telehealth clinical assessment, health education, and utilization management services to a variety of beneficiaries. Registered Nurses provide telephone triage and health advice to callers across North America remotely, from the comfort of their own home office. All calls are documented electronically, and all telephone encounters are recorded.

This job involves reviewing medical records for medical necessity, providing skilled nursing care, completing patient evaluations, and ensuring timely review of requests for post-acute services based on clinical guidelines. The Utilization Review Clinician will comply with standard operating procedures, departmental, and organizational policies, fostering relationships with healthcare providers to improve health outcomes.

The RN Clinical Field Staff Liaison (CFSL) provides support and acts as a resource to clinicians in the field, monitoring compliance, quality, and safe delivery of services. The CFSL assists in following a clinical process set by clinical management and is responsible for practices and duties within the scope of practice.