Medicaid Nurse Reviewer & Medical Necessity Lead
Listed on 2026-09-26
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Nursing
Healthcare Nursing, Nurse Educator, Clinical Nurse Specialist, Mental Health Nurse
State-of-West-Virgini seeks a nurse reviewer to perform pre- and post-payment Medicaid service reviews, assessing medical necessity and documentation against policy. You will serve as lead on complex cases and prepare reports for the Medicaid program administrator.
Requirements include a nursing degree with WV license, several years of nursing experience and professional certification preferred; strong communication with providers and the ability to develop procedures with program staff.
Step into the Medicaid Nurse Reviewer & Medical Necessity Lead role at State-of-West-Virgini in WV, United States and grow with us.
This is a strong role to take on the Medicaid Nurse Reviewer & Medical Necessity Lead role at State-of-West-Virgini.
As a Medicaid Nurse Reviewer & Medical Necessity Lead, you will play an important part at State-of-West-Virgini in WV, United States.
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