Clinical Review Nurse I

About This Role

The Clinical Review Nurse I is responsible for reviewing and making medical determinations regarding claims to ensure they meet the benefits carried by members. This role is ideal for individuals seeking a flexible, virtual work environment while contributing to healthcare decision-making.

Highlights

• Location: Atlanta, GA


• Schedule: Full-time, Virtual

What You'll Do

• Assess the necessity and reasonableness of items supplied in valid claims using medical policy and other materials.

Requirements

Education:

• AS in nursing required, BS in nursing preferred

Experience:

• Minimum of 1 year of clinical experience

Licenses & Certifications:

• Current unrestricted RN license required

Benefits:

• Merit increases


• Paid holidays


• Paid Time Off


• Incentive bonus programs


• Medical, dental, and vision benefits


• Short and long-term disability benefits


• 401(k) + match


• Stock purchase plan


• Life insurance


• Wellness programs


• Financial education resources

About Elevance Health

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. They are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels who are passionate about making an impact on their members and communities.