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Clinical Review - Contract Position in Concord, NH at KEPRO

Date Posted: 3/17/2018

Job Snapshot

  • Employee Type:
  • Location:
    Concord, NH
  • Job Type:
    Health Care
  • Experience:
    At least 2 year(s)
  • Date Posted:

Job Description

RN Clinical Reviewer – Contract Position

Performs determinations to adults with chronic illness or disability and who are either Medicaid recipients or are seeking Medicaid as payment for long term services, in the community using the Medical Eligibility Assessment tool.

    • Evaluate assessment and care management data to determine ongoing eligibility, care needs, and service options. Assist in making Level of Care determinations as part of initial, annual, and event-based (if applicable) assessment process.
    • Monitor and evaluate the individualized care plan, service quality and program eligibility.
    • Apply judgments and perform clinical practice based upon education, experience, and professional practice standards.
    • Participate in trainings, meetings, in-services and continuing education opportunities
    • Ensures accurate and timely submission of all administrative and related documents to appropriate parties.
    • Monitors and complies with all Client and KEPRO requirements relative to accuracy and timeliness. Maintains production goals and QA standards.


  • Active non-restricted New Hampshire RN license required
  • Preferred:   2 years clinical experience or experience conducting Level of Care Determinations
  • Travel is required – must have active/clear drivers’ license
  • Demonstrated knowledge and experience with relevant social service/rehabilitation systems.
  • Knowledge of applicable state regulations
  • Must be proficient with MS Office 
  • Excellent communication, organization & team building skills plus a strong focus on customer service & provider relations required. 
  • Ability to maintain a positive attitude and contribute both as an individual and a team member to achieve the goals of the department. 
  • Ability to successfully respond to change and juggle multiple and changing priorities with sometimes conflicting deadlines

For consideration, please submit resume and cover letter with salary requirements. Only those candidates identified for an interview will be contacted. No Phone Calls Please.  Visit our website at for more information on the KEPRO Family of Companies