Remote Clinical Review Nurse — Assess Validity
Atlanta, Fulton County, Georgia, 30383, USA
Listed on 2026-10-20
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Nursing
RN Nurse, Healthcare Nursing
Elevance Health seeks a Clinical Review Nurse I to assess medical necessity and determine benefits for member claims. The role supports hybrid work with required in-person training sessions and CMS residency eligibility. A valid RN license and nursing experience are essential, with AS or BS as preferred credentials.
The position emphasizes policy-based decision making, with duties including evaluating item necessity in claims using established medical criteria and policy guidelines.
The following role is for a Remote Clinical Review Nurse I — Assess Benefit Validity with Elevance Health (Anthem).
This opportunity is part of our work in Bio & Pharmacology & Health.
The advertised compensation is 70.000 - 95.000.
We aim to respond to suitable candidates as soon as possible.
Full responsibilities and requirements are described in the listing above.
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