require a current, unrestricted nursing license (i.e. RN) in the applicable state, as indicated in the function.... Licensure includes RN, depending on grade level, with current unrestricted licensure in applicable state. General Job Profile...
is assigned to the appropriate team for review (e.g., Medicare, Medicaid, Commercial) -Validate that cases/requests for services..., medical necessity) CPS_Review Existing Clinical Documentation Review/interpret clinical/medical records submitted...