Clinical Review Nurse I

🔥 11 minutes ago

🐊 Florida, Ohio, +1 more states – Remote

🐊 Florida – Remote 🏈 Ohio – Remote 🤠 Texas – Remote

⏰ Full Time

🟢 Junior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Elevance Health

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 B2B

Healthcare • Healthcare Insurance • B2B

Elevance Health is transforming from a traditional health benefits organization into a lifetime trusted health partner, driven by a bold purpose to improve the health of humanity. With nearly 100,000 associates, they serve over 118 million people and utilize an integrated whole health approach supported by industry-leading capabilities and a digital health platform. Their mission includes redefining health, reimagining the health system, and strengthening communities.

📋 Description

• Review claims and make medical determinations as to whether claims meet the member's benefits • Assess the necessity and reasonableness of items supplied in a valid claim using medical policy and other materials • Complete required in-person training sessions, onboarding, and skill development

🎯 Requirements

• AS in nursing and minimum of 1 year of clinical experience; or any combination of education and experience, which would provide an equivalent background • Current unrestricted RN license required • Foreign national applicants must meet the residency requirement of living in the United States at least three of the past five years • Ability to comprehend medical policy and criteria to clearly articulate health information strongly preferred • BS in nursing preferred • COVID-19 and Influenza vaccination required for new candidates in certain patient/member-facing roles, unless an acceptable explanation is provided • Must reside within a commuting distance from an office/posting location unless accommodation is granted as required by law

🏖️ Benefits

• merit increases • paid holidays • Paid Time Off • incentive bonus programs • medical benefits • dental benefits • vision benefits • short and long term disability benefits • 401(k) +match • stock purchase plan • life insurance • wellness programs • financial education resources • Virtual full-time work, except for required in-person training sessions • maximum flexibility and autonomy • work-life integration • required face-to-face onboarding and skill development