Tennessee Licensed Clinical Review Manager
VirtualVocationsOntario, California, United Statesjob_description.job_card.variable_hours_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
Licensed Clinical Manager • Ontario, California, United States
Job_description.internal_linking.related_jobs A company is looking for a Clinical Manager - Part-Time.Key Responsibilities Report directly to the Director of Therapy and manage a cohort of providers Maintain a clinical caseload and engage i...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours A company is looking for Board Certified Physician Reviewers specializing in Urology with a Minnesota license.Key Responsibilities Evaluate medical records and provide clinical summaries Engage ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 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 ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours A company is looking for a Manager, Vendor Clinical Policy to join their Clinical Policy team.Key Responsibilities Evaluate vendor policy sets to ensure compliance with internal and external medi...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours 
Psychiatric Technician - Statewide in CA Position : Psychiatric Technician Location : Statewide - Multiple Locations Throughout California Annual Salary Range : $71,460 - $105,084 California Correctio...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
When you join the Huntington Hospital team, you are aligning yourself with an organization whose values drive our philosophy of compassionate community care.
Over the past 129 years, we’ve gro...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
Construction Project Manager – Construction (Retail & Commercial Focus).Long Beach (Hybrid – 3 days in office, 2 remote).
Flexible, depending on project needs (occasional early mornings or weekends)...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
Intuit is seeking highly motivated individuals to join our dynamic team as dedicated TurboTax Live Seasonal Local Service Experts in one of our new TurboTax locations across the United States on a ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days A company is looking for a Clinical Review Nurse - Concurrent Review.Key Responsibilities Perform concurrent reviews to assess member health and appropriate level of care Review quality and cont...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 A company is looking for a Clinical Documentation Specialist RN.Key Responsibilities Conducts concurrent reviews of clinical documentation in medical records to ensure compliance and accuracy for...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days 
These are some of Skilled Wound Care's core values; we are seeking the absolute best people in healthcare to help us change the way that care is delivered.
Skilled Wound Care is looking for a.RN...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours A company is looking for a Clinical Appeals RN to work on post-service appeals for Medicare-based claims remotely.Key Responsibilities : Review provider post-service appeals for Medicare and Retir...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days A company is looking for a LOS Clinical Review Coordinator for TN and MO.Key Responsibilities Request and review member's clinical information from providers Perform utilization review of inpati...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours 
At LifeStance Health, we believe in a truly healthy society where mental and physical healthcare are unified to make lives better.
Our mission is to help people lead healthier, more fulfilling lives...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
TravelNurseSource is working with FlexCare to find a qualified Labor / Delivery RN in Murrieta, California, 92562!.FlexCare is a nationwide leader in the staffing of travel nurses and clinicians.With...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days A company is looking for a Manager, Vendor Clinical Policy to join their Clinical Policy team.Key Responsibilities Clinically evaluate vendor policy sets for compliance with medical standards and...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours A company is looking for a Registered Nurse (RN), Auditor.Key Responsibilities Review bills for accuracy compared to medical records Identify and correct ongoing problems through documentation r...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours A company is looking for a Licensed Clinical Therapist (LCSW / LMHC / LMFT) for an Adult Intensive Outpatient Virtual Group.
Key Responsibilities Provide virtual IOP remote group coverage via video co...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 
Looking for a change of scenery and a chance to help others? Join Jackson Therapy Partners as a traveling Physical Therapist where you’ll help patients recover from injuries and manage chronic cond...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
AlliedTravelCareers is working with Host Healthcare to find a qualified Physical Therapist (PT) in Hesperia, California, 92345!.
Host Healthcare is an award-winning travel healthcare company with an...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
Licensed Clinical Manager
VirtualVocationsOrange, California, United Statesserp_jobs.job_card.part_time
- serp_jobs.job_card.promoted
Minnesota Licensed Urology Reviewer
VirtualVocationsPasadena, California, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
Tennessee Licensed Clinical Review Manager
VirtualVocationsCorona, California, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
Texas Licensed Clinical Policy Manager
VirtualVocationsWhittier, California, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Psychiatric Technician - Statewide in CA
California Department of Corrections and RehabilitationWrightwood, California, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Clinical Manager, Critical Care Unit
Huntington HospitalPasadena, CA, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
Construction Project Manager
Vaco by HighspringAltadena, California, United Statesserp_jobs.job_card.permanent
- serp_jobs.job_card.promoted
Tax Expert - Onsite
IntuitPhelan, CA, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Texas Licensed Clinical Review Nurse
VirtualVocationsHuntington Beach, California, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Colorado Licensed Clinical Documentation Specialist RN
VirtualVocationsMission Viejo, California, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
RN / LVN Regional Clinical Liaison - Anaheim, CA
Skilled Wound CareAnaheim, CA, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Maryland Licensed Clinical Appeals RN
VirtualVocationsWhittier, California, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
Tennessee and Missouri RN Clinical Review Coordinator
VirtualVocationsFullerton, California, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Licensed Mental Health Therapist (LMFT, LCSW, LPCC) - Mt Baldy, CA
LifeStance HealthMount Baldy, CA, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Travel Nurse RN - Labor / Delivery - $1,565 per week in Murrieta, CA
TravelNurseSourceMurrieta, CA, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
Georgia Licensed Clinical Policy Manager
VirtualVocationsCorona, California, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
Tennessee Licensed RN Auditor
VirtualVocationsNorwalk, California, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Florida Licensed Clinical Therapist
VirtualVocationsHuntington Beach, California, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Physical Therapist - Travel Contract
Jackson Therapy PartnersHesperia, CA, United Statesserp_jobs.job_card.full_time +1
- serp_jobs.job_card.promoted
Travel Physical Therapist (PT) - $2,461 to $2,640 per week in Hesperia, CA
AlliedTravelCareersHesperia, CA, USserp_jobs.job_card.full_time