Job Summary
The Review Nurse evaluates Medicaid applicants’ clinical medical records to determine whether they meet established criteria for medical frailty. The role works closely with multidisciplinary teams and physician reviewers to support prompt, accurate decisions and complete documentation.
Responsibilities
- Review clinical records for Medicaid applicants and assess medical frailty against established criteria.
- Coordinate with multidisciplinary team members and physician reviewers throughout the determination process.
- Help ensure determinations are timely, accurate, and supported by clear clinical documentation.
Qualifications
- Registered Nurse with an active Georgia license.
- Three to five years of recent clinical experience.
- Proficiency in medical record review and clinical documentation.
- A bachelor’s degree in nursing is preferred.
Alliant Health Solutions, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
