TRICARE Medical Review Nurse

• Review incoming medical reports to ensure accuracy and completeness; flag quality concerns when needed.
• Close cases where care has been completed.
• When follow-up care is needed, assess whether the requested services are medically appropriate and issue authorization letters.
• Forward cases to regional clinical teams when specialized local expertise is required.
• Provide beneficiaries with non-urgent follow-up recommendations via email.

• Evaluate requests for additional treatment or specialist referrals to ensure they meet program guidelines.
• Work daily with our administrative teams on cases that require clinical input.
• Escalate complex clinical situations or concerns to the Medical Review Nurse Team Leader.

• Maintain strict confidentiality and ensure all medical information is handled appropriately.
• Keep accurate, compliant case files.
• Respond promptly and professionally to questions from beneficiaries and colleagues.
• Participate in internal meetings as needed.

• Registered Nurse in your country of origin/residence.
• Broad clinical nursing experience (acute care preferred) with at least 2 years of bedside nursing preferred.
• Experience with case review, utilization review, or medical documentation is a plus, but not required.
• Very good knowledge of written and spoken English and medical terminology
• Strong computer skills (MS Office), ability to learn and work with new systems
• Ability to follow procedures, work systematically, and keep high standards of quality.
• Strong attention to detail and excellent communication skills.
• A team-oriented mindset and a strong focus on beneficiary care.

• A diverse and international environment
• Flexible working hours
• 5 weeks of holiday + 5 personal time off days
• Meal allowance, pension contribution, benefit card, Multisport, and more
• Modern offices in Prague - Anděl
• Permanent contract with competitive compensation

International SOS