Virginia Licensed Clinical Reviewer
VirtualVocationsNewport News, Virginia, 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 Lead Clinical Reviewer.
Key Responsibilities
Review medical records against criteria to determine medical appropriateness
Guide team members and support training and documentation efforts
Perform quality monitoring and audits to identify areas for improvement
Required Qualifications
Active and unrestricted Licensed Clinical Social Worker (LCSW) license for the state of Virginia
Master's degree from an accredited college in a relevant degree program
2+ years of experience in Prior Authorization, Utilization Review (UR), or Utilization Management (UM)
serp_jobs.job_alerts.create_a_job
Clinical Reviewer • Newport News, Virginia, United States
Job_description.internal_linking.related_jobs A company is looking for a Clinical Reviewer, Physical Therapy.Key Responsibilities Evaluate cases that do not pass the authorization approval process and promote a supportive team approach Revi...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours A company is looking for a Medical Review Clinical QA Auditor (RN) - Home Health & Hospice.Key Responsibilities : Conduct quality assurance reviews on medical review audit work to ensure accuracy ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day A company is looking for a Clinical Assessor, Mid - RN - Full-time (Remote U.Key Responsibilities Conduct assessments for Medicaid Waiver eligibility using state-approved tools Ensure privacy an...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day A company is looking for a Manager, Clinical Navigation.Key Responsibilities Lead and develop a team of Clinical Navigators to enhance patient engagement and outcomes Oversee daily operations of...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours A company is looking for a Clinical Government Audit Analyst & Appeal Specialist II (Remote).Key Responsibilities Conduct thorough analyses of denials and ensure accurate coding while identifying...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 New Mexico License.Key Responsibilities Evaluate medical records and provide clinical summaries Engage...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day 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_days A company is looking for a Clinical Other - Abstract RN.Key Responsibilities Conduct electronic medical record abstraction services accurately and efficiently Abstract information from electroni...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours A company is looking for a Lead Clinical Reviewer.Key Responsibilities Review medical records against criteria to determine medical appropriateness Guide team members and support training and do...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 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_1_day A company is looking for Board Certified Physician Reviewers specializing in Urology with a Virginia License.Key Responsibilities Evaluate medical records and provide clinical summaries Engage i...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day A company is looking for a Clinical Review Nurse - Concurrent Review.Key Responsibilities Performs concurrent reviews to determine members' overall health and appropriate level of care Reviews q...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 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_1_day A company is looking for a Medical Bill Reviewer-100% remote (EST or CST time zone).Key Responsibilities Identify provider participation status when automated processes fail Apply PPO guidelines...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day A company is looking for a Clinical Quality Associate (Remote).Key Responsibilities Manage the clinical support inbox and respond to inquiries from internal teams, providers, and patients Interp...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours A company is looking for a Clinical Appeals Coordinator.Key Responsibilities Act as the liaison for statewide appeals, ensuring compliance with State and NCQA requirements Review clinical inform...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours A company is looking for a VP, Clinical Services to provide leadership and oversight for Clinical Services and Casualty departments.
Key Responsibilities Oversee all Clinical Services functions an...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day 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_1_day 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_1_day
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
Licensed Physical Therapy Reviewer
VirtualVocationsVirginia Beach, Virginia, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
RN Clinical QA Auditor
VirtualVocationsVirginia Beach, Virginia, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
South Carolina Licensed Clinical Assessor
VirtualVocationsVirginia Beach, Virginia, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
TX and GA Licensed Clinical Manager
VirtualVocationsVirginia Beach, Virginia, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
Clinical Audit Analyst II - RN Licensed
VirtualVocationsVirginia Beach, Virginia, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
New Mexico Licensed Urology Reviewer
VirtualVocationsVirginia Beach, Virginia, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Tennessee Licensed Clinical Review Manager
VirtualVocationsVirginia Beach, Virginia, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
Texas Licensed Clinical Abstract RN
VirtualVocationsVirginia Beach, Virginia, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
Virginia Licensed Clinical Reviewer
VirtualVocationsVirginia Beach, Virginia, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Minnesota Licensed Urology Reviewer
VirtualVocationsVirginia Beach, Virginia, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Tennessee and Missouri RN Clinical Review Coordinator
VirtualVocationsVirginia Beach, Virginia, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Virginia Licensed Urology Reviewer
VirtualVocationsVirginia Beach, Virginia, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Florida Licensed Clinical Review Nurse
VirtualVocationsVirginia Beach, Virginia, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Licensed Clinical Manager
VirtualVocationsVirginia Beach, Virginia, United Statesserp_jobs.job_card.part_time
- serp_jobs.job_card.promoted
Medical Bill Reviewer
VirtualVocationsVirginia Beach, Virginia, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
Licensed Clinical Quality Associate
VirtualVocationsVirginia Beach, Virginia, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
Texas Licensed Clinical Appeals Coordinator
VirtualVocationsVirginia Beach, Virginia, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
NC Licensed Clinical Services VP
VirtualVocationsVirginia Beach, Virginia, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Texas Licensed Clinical Policy Manager
VirtualVocationsVirginia Beach, Virginia, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Georgia Licensed Clinical Policy Manager
VirtualVocationsVirginia Beach, Virginia, United Statesserp_jobs.job_card.full_time