serp_jobs.error_messages.no_longer_accepting
Tennessee Licensed Clinical Review Manager
VirtualVocationsStaten Island, New York, United Statesjob_description.job_card.variable_days_ago
serp_jobs.job_preview.job_type
- serp_jobs.job_card.full_time
job_description.job_card.job_description
A company is looking for a Clinical Review Manager to oversee clinical information and ensure appropriate care for members.
Key Responsibilities
Research clinical information from providers using CMS guidelines to ensure members receive necessary services
Initiate referrals and coordinate care while consulting with the Medical Director as needed
Assist with administrative reviews and perform comprehensive appeals and claim reviews
Required Qualifications
Active Registered Nurse (RN) license in Tennessee or a participating Nurse Licensure Compact state
Minimum of 3 years of clinical experience
Proficiency in Microsoft Office (Outlook, Word, Excel, PowerPoint)
Knowledge of URAC, NCQA, and CMS accreditations
Ability to work independently in a fast-paced environment
serp_jobs.job_alerts.create_a_job
Review Manager • Staten Island, New York, United States
Job_description.internal_linking.related_jobs
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care.
The work you do here impacts the lives of millions of people ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 A company is looking for a Clinical Performance Improvement Coordinator.Key Responsibilities Facilitates the review, investigation, and processing of clinical event referrals Monitors, analyzes,...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours 
Become a part of our caring community and help us put health first.This is not a remote or work-from-home position.This position requires you to sit on-site at our Westbury, NY branch location.This...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Access and Reimbursement Manager (ARM) is a field-based role that proactively provides in person (or virtual as needed) education to defined accounts within their assigned geographies on a wide ran...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days Access and Reimbursement Manager (ARM) is a field-based role that proactively provides in person (or virtual as needed) education to defined accounts within their assigned geographies on a wide ran...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days A company is looking for a Clinical Case Manager Behavioral Health - Work at Home.Key Responsibilities Conduct comprehensive assessments of members' needs and eligibility for services Facilitate...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days 
Provides support for clinical member services review assessment processes.Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance p...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
FlexStaff is looking for a Clinical Nurse Managers in a variety of locations within New York.The Clinical Manager - Integrated Care plays an essential role in ensuring that participants in contract...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Critical Illness Recovery Hospital (LTACH) - NYC Territory.Annual Salary Range : $75,000 - $110,000 plus uncapped monthly bonus incentives.
Starting salary relates to years of relevant work experienc...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
RN-Director of Clinical Services-Community Health.The Parker Jewish Institute for Healthcare and Rehabilitation, located in New Hyde Park, NY, is seeking an RN-Director of Clinical Services skilled...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 A company is looking for a Clinical Vendor Manager to oversee clinical vendor partnerships and ensure effective delivery of clinical programs and services.
Key Responsibilities Serve as the primar...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours 
As a Clinical Reviewer, you will complete the full spectrum of activities related to Utilization or Quality reviews as assigned.
You will utilize their knowledge and expertise of the review program ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, inc...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes.Responsible for verifying that services are medically necessary and align with established clini...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days 
To ensure overall responsibility for one or more nursing units and assure the highest degree of quality resident care is maintained at all times.
Ensures that all Residents Rights are adhered to by ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
New Yorkers by uniting communities through care.We believe that Health care is a right, not a privilege.If you have compassion and a collaborative spirit, work with us.
You can come to work being pr...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days Access and Reimbursement Manager (ARM) is a field-based role that proactively provides in person (or virtual as needed) education to defined accounts within their assigned geographies on a wide ran...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days A company is looking for a Manager Clinical Pharmacy Client Services.Key Responsibilities Manages and provides leadership to a clinical team, focusing on mentorship and performance management Le...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours A company is looking for a Clinical Denials & Appeals Specialist (Remote).Key Responsibilities Review and respond to Corporate Compliance Audits and denial trends Prepare and defend level of car...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 
JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes.Responsible for verifying that services are medically necessary and align with established cl...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
- serp_jobs.job_card.promoted
Clinical Transformation Manager - Tri-State Area - Remote
UnitedHealth GroupNew York, NY, United Statesserp_jobs.filters.remote
serp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
Florida Licensed Clinical Coordinator
VirtualVocationsNew York, New York, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
RN Clinical Manager
CenterWell Home HealthWestbury, NY, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Access & Reimbursement Manager (ARM) - Renal - Minneapolis (Remote)
Novartis Group CompaniesEast Hanover, NJ, United Statesserp_jobs.filters.remote
serp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Access & Reimbursement Manager - CV - Miami (Remote)
Novartis Group CompaniesEast Hanover, NJ, United Statesserp_jobs.filters.remote
serp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Licensed Clinical Case Manager
VirtualVocationsNewark, New Jersey, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Care Review Clinician (RN)
Molina HealthcareCorona, NY, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Clinical RN Manager- Integrated Care
Northwell HealthNew York, NY, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Clinical Account Manager
Select Medical HoldingsNew York, NY, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
RN-Director of Clinical Services-Community Health
Parker Jewish Institute for Health Care and RehabilitationNew Hyde Park, NY, USserp_jobs.job_card.full_time +1
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
RN Clinical Vendor Manager
VirtualVocationsBronx, New York, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Clinical Reviewer (RN)
ISLAND PEER REVIEW ORGANIZATION INCJericho, NY, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Care Review Clinician, PA (RN)
Molina HealthcareNew York City, NY, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Care Review Clinician, Inpatient Review (RN)
Molina HealthcareCorona, NY, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Clinical Manager
BronxCare Health SystemBronx, NY, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Clinical Pharmacy Manager
MetroPlusHealthNew York, NY, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Access & Reimbursement Manager (ARM) - Renal - Long Beach, CA (Remote)
Novartis Group CompaniesEast Hanover, NJ, United Statesserp_jobs.filters.remote
serp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
Oregon Licensed Clinical Pharmacy Manager
VirtualVocationsAstoria, New York, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
New York Licensed Clinical Appeals Specialist
VirtualVocationsElizabeth, New Jersey, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Care Review Clinician (RN) (Must reside in MI)
Molina HealthcareStaten Island, NY, United Statesserp_jobs.job_card.full_time