Clinical Nurse Reviewer

requirements, and organizational policies. Support administrative tasks such as data entry, case tracking, and report preparation. Participate in training sessions and shadow senior reviewers to develop clinical review skills. Maintain personal production metrics and quality assurance scores consistently Maintain awareness of and ensure adherence to Zelis standards regarding privacy What You’ll Bring to Zelis: Typically has a BA or 3-5 years of experience; Attends company training and local meetings in field Requires proficiency using AI tools skillfully with an understanding of how to develop/create intelligent prompts and/or agents. Experience and working knowledge of Health Insurance, Medicare guidelines and various healthcare programs preferred Familiarity with EHR systems and Microsoft Office. Exceptional attention to detail and ability to follow established processes. Committed to continuous learning and professional development, with a passion for improving healthcare quality and outcomes. Proactive and self-motivated, with a strong sense of ownership and accountability. Ability to withstand long period of computer work while utilizing multiple computer screens at one time Please note at this time we are unable to proceed with candidates who require visa sponsorship now or in the future. Location and Workplace Flexibility Zelis is headquartered in the U.S., with multiple locations across the country and in Hyderabad, India. Check out our locations to learn more about our offices. All employee work locations are based on the needs of the position and are determined by the Leadership team. In-office work and activities vary based on work and team objectives in accordance with Company policies. While location expectations vary by role, candidates within approximately 50 miles of a U.S. office are generally preferred to support collaboration when needed. Our hybrid approach is flexible, and in-office presence is guided by team and business needs rather than a fixed weekly schedule. Base Salary Range $59,000.00 - $75,050.00 At Zelis we are committed to providing fair and equitable

compensation packages. The base salary range allows us to make an offer that considers multiple individualized factors, including experience, education,

qualifications, as well as job-related and industry-related knowledge and skills, etc. Base pay is just one part of our Total Rewards package, which may also include discretionary

bonus plans, commissions, or other incentives depending on

the role. Zelis’ full-time associates are eligible for a highly competitive

benefits package as well, which demonstrates our commitment to our employees’ health, well-being, and financial protection. The US-based

benefits include a 401k plan with employer match, flexible paid time off, holidays, parental leaves, life and disability insurance, and health

benefits including medical, dental, vision, and prescription drug coverage. Equal Employment Opportunity Zelis is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. We welcome applicants from all backgrounds and encourage you to apply even if you don’t meet 100% of the

qualifications for

the role. We believe in the value of diverse perspectives and experiences and are committed to building an inclusive workplace for all. Accessibility Support We are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability or a disabled veteran and require a reasonable accommodation with any part of the application and/or interview process, please email [email protected]. Disclaimer The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all

responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal

responsibilities, duties, and skills from time to time. Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers. We serve more than 750 payers, including the top five national health plans, regional health plans, TPAs and millions of healthcare providers and consumers across our platform of solutions. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts – driving real, measurable results for clients. Zelis maintains a transparent, fee-free recruitment process. All genuine offers originate from our Talent Acquisition team using the “@zelis.com” domain. We do not use WhatsApp or personal emails for recruitment. Forward any suspected fraud to [email protected] for prompt investigation. Thank you for staying vigilant.

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