Clinical Utilization Review Nurse — Safeguard Care & Outcomes
Job in
Northern, Floyd County, Kentucky, USA
Listed on 2026-08-13
Listing for:
Personify Health
Full Time
position Listed on 2026-08-13
Job specializations:
-
Healthcare
Job Description & How to Apply Below
Personify Health is hiring an LVN-licensed reviewer to assess outpatient, inpatient, and mental health pre-certifications for medical appropriateness and necessity. You will also drive post-service reviews to verify medical necessity, escalate complex cases, and coordinate discharge planning with hospital staff.
Your role includes handling appeals for non-certified services, routing cases to appropriate decision-makers, and ensuring all reviews are documented in Eldorado/Episodes with strict
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