RN Medical Reviewer III (W@H SC)

Company: BlueCross BlueShield of South Carolina | Location: W@H South Carolina | Employment: Full-time | License: RN | State licensure: South Carolina

Summary We are currently hiring for an RN Medical Reviewer III to join BlueCross BlueShield of South Carolina. In this role as an RN Medical Reviewer III, you will perform medical reviews using clinical/medical information provided by physicians/providers and established criteria/protocol sets or clinical guidelines, document decisions using indicated protocol sets or clinical guidelines, and provide support and review of medical claims and utilization practices. Description Location: This position is full-time (40 hours/week) Monday-Friday, working an 8-hour shift between 6:00am – 5:00pm and will be fully remote after 1-2 weeks of on-site training in Columbia, SC. The candidate will be required to report on-site occasionally for trainings, meetings, or other business needs.