Medical Reviewer

• Complete in-home nursing assessments of eligible members
• Conduct person-centered assessments focused on members' functional abilities and needs
• Work with provider agencies to ensure services are delivered as authorized

Remote RN conducting in-home assessments for the Medicaid program in Montana

RN – Clinical Field Reviewer

Remote RN conducting in-home assessments for eligible members in Montana. Collaborating with care providers and empowering members through effective nursing practices.

• Perform accurate and timely medical review of claims suspended for medical necessity
• Initiate and/or respond to correspondence from providers or members concerning medical determinations

Medical Reviewer II responsible for reviewing medical claims for HCSC

Medical Reviewer II

Medical Reviewer II at HCSC responsible for performing medical review of claims and responding to correspondence. Requires RN license and clinical experience.

Medical Reviewer jobs in Montana

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RN – Clinical Field Reviewer

Medical Reviewer II