Licensed Clinical ReviewerVirtualVocations • Paterson, New Jersey, United States
Licensed Clinical Reviewer
VirtualVocations • Paterson, New Jersey, United States
job_description.job_card.30_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 Reviewer of Behavioral Health.
Key Responsibilities
Review medical records to determine medical appropriateness based on contract requirements
Monitor and adjust daily workload to meet departmental demands and ensure timely case reviews
Act as a liaison for providers and assist in quality monitoring and improvement activities
Required Qualifications
Active unrestricted Licensed Mental Health Professional (LMHP) in relevant fields
Bachelor's Degree or higher in a related field from an accredited institution
At least 1 year of experience in Prior Authorization, Utilization Review, or Utilization Management
Ability to work alternating weekends
serp_jobs.job_alerts.create_a_job
Clinical Reviewer • Paterson, New Jersey, United States
Job_description.internal_linking.related_jobs
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 hea...serp_jobs.internal_linking.show_more
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_more
Host Healthcare is seeking a travel nurse RN Clinical Liaison for a travel nursing job in Cortlandt Manor, New York.Job Description & Requirements.
Pay package is based on 8 hour shifts and 40 h...serp_jobs.internal_linking.show_more
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_more 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_more 
Aveanna is compassion and passion rolled into one inspired purpose.It’s anything you want to find and everything you’re looking for.
It’s a place where caring is more personal beca...serp_jobs.internal_linking.show_more A company is looking for a Manager of Clinical Review to oversee clinical operations and ensure high-quality patient care.
Key Responsibilities Monitor quality of care and compliance with policies...serp_jobs.internal_linking.show_more A company is looking for a Manager, Clinical Policy to join their Clinical Policy team.Key Responsibilities Clinically evaluate vendor policy sets to ensure compliance with internal and external ...serp_jobs.internal_linking.show_more A company is looking for a Manager, Clinical Policy to join their Clinical Policy team.Key Responsibilities Evaluate vendor policy sets for compliance with internal and external medical standards...serp_jobs.internal_linking.show_more 
RN Clininical Compliance Coordinator | NJ, Newton.We are an equal employment opportunity employer.All qualified applicants will receive consideration for employment without regard to race, color, r...serp_jobs.internal_linking.show_more A company is looking for a Clinical Reviewer of Behavioral Health.Key Responsibilities Review medical records to determine medical appropriateness based on contract requirements Monitor and adju...serp_jobs.internal_linking.show_more A company is looking for a DRG Reviewer to join their remote Payment Integrity team.Key Responsibilities Analyze and review inpatient claims for adherence to Official Coding and Reporting Guideli...serp_jobs.internal_linking.show_more 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 hea...serp_jobs.internal_linking.show_more JOB DESCRIPTION Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of ca...serp_jobs.internal_linking.show_more Host Healthcare is seeking a local contract nurse RN Clinical Liaison for a local contract nursing job in Cortlandt Manor, New York.
Job Description & Requirements.Pay package is based on 8 hour...serp_jobs.internal_linking.show_more 
Perform clinical and administrative reviews within the Grievance and Appeals department, ensuring accurate administration of benefits, execution of clinical policy, timely access to appropriate lev...serp_jobs.internal_linking.show_more
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_more
Licensed Clinical Social Worker LCSW.Are you passionate about working with an underserved and rewarding population? Looking for a clinical role without the administrative burden, and one that offer...serp_jobs.internal_linking.show_more We are actively looking to hire talented therapists in the Yorktown Heights, NY area, who are passionate about patient care and committed to clinical excellence.
Wanting to deliver high quality beha...serp_jobs.internal_linking.show_more A company is looking for an RN Utilization Management Reviewer.Key Responsibilities : Conduct pre-certification, concurrent, and retrospective reviews focusing on utilization management and care c...serp_jobs.internal_linking.show_more
Inpatient DRG Reviewer
Zelis Healthcare, LLC • Morristown, NJ, United States
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Care Review Clinician (RN)
Molina Healthcare • Yonkers, New York, United States
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
Travel Nurse RN - Clinical Liaison
Host Healthcare • Cortlandt Manor, NY, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Licensed Therapist (LCSW, LMHC, LMFT) - Cold Spring, NY
LifeStance Health • Cold Spring, NY, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Licensed Clinical Social Worker (LCSW) - Tomkins Cove, NY
LifeStance Health • Tomkins Cove, NY, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Clinical Director - Home Care - RN
Aveanna Healthcare • Clark, NJ, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
RN Clinical Review Manager
VirtualVocations • Paterson, New Jersey, United States
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Texas Licensed Clinical Policy Manager
VirtualVocations • New York, New York, United States
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Georgia Licensed Clinical Policy Manager
VirtualVocations • New York, New York, United States
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
RN Clininical Compliance Coordinator | NJ, Newton
KAREN ANN QUINLAN MEMORIAL FOUNDATION • Newton, NJ, US
serp_jobs.job_card.full_time +1
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Licensed Clinical Reviewer
VirtualVocations • Jackson Heights, New York, United States
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Certified DRG Reviewer
VirtualVocations • Elizabeth, New Jersey, United States
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Inpatient DRG Sr. Reviewer
Zelis Healthcare, LLC • Morristown, NJ, United States
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Care Review Clinician, PA (RN)
Molina Healthcare • Yonkers, New York, United States
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_1_hour • serp_jobs.job_card.promoted • serp_jobs.job_card.new
Local Contract Nurse RN - Clinical Liaison
Host Healthcare • Cortlandt Manor, NY, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Clinical Reviewer, Grievance & Appeals (Remote)
EmblemHealth • New York, NY, United States
serp_jobs.filters.remote
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Clinical Manager
BronxCare Health System • Bronx, NY, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Licensed Clinical Social Worker
SENIOR CARE THERAPY • Middletown, NY, US
serp_jobs.job_card.full_time +1
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Licensed Clinical Social Worker (LCSW) - Stony Point, NY
LifeStance Health • Stony Point, NY, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Massachusetts Licensed RN Reviewer
VirtualVocations • Astoria, New York, United States
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted