Medicaid Nurse Reviewer & Medical Necessity Lead
Listed on 2026-09-30
-
Nursing
Healthcare Nursing
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.
This is a genuine position to take on the Medicaid Nurse Reviewer & Medical Necessity Lead role at State-of-West-Virgini.
The position is based in WV, United States.
This opportunity is part of our work in Bio & Pharmacology & Health.
The advertised compensation is 65.000 - 90.000.
We aim to respond to suitable candidates as soon as possible.
Full responsibilities and requirements are described in the listing above.
(If this job is in fact in your jurisdiction, then you may be using a Proxy or VPN to access this site, and to progress further, you should change your connectivity to another mobile device or PC).