Talent.com
Tennessee Licensed Clinical Review Manager

Tennessee Licensed Clinical Review Manager

VirtualVocationsWashington, District of Columbia, 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 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 • Washington, District of Columbia, United States

Job_description.internal_linking.related_jobs
  • serp_jobs.job_card.promoted
Clinical Manager

Clinical Manager

Kolmac ClinicBaltimore, MD, US
serp_jobs.job_card.full_time
Kolmac Integrated Behavioral Health and Concerted Care Group (CCG) is a leading outpatient treatment provider in the Mid-Atlantic region. We are committed to treating individuals whose lives have be...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Medical Review Manager

Medical Review Manager

Saratoga Medical CenterCatonsville, MD, US
serp_jobs.job_card.full_time
Saratoga Medical has an immediate opening for a Medical Review Manager for a program supporting the Centers for Medicare and Medicaid Services (CMS) in Catonsville, MD. The work hours are Monday to ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Manager

Manager

LifeBridge HealthBaltimore, MD, US
serp_jobs.job_card.full_time
Manager, Central Sterile Processing.Responsible for planning, developing, budgeting to insure operational and fiscal efficient are maintained. facilitating and coordinating the operation of the Ste...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Clinical Reimbursement Coordinator, RN

Clinical Reimbursement Coordinator, RN

Larkin Chase CenterBowie, MD, United States
serp_jobs.job_card.full_time
Overview : At Genesis Healthcare, we are dedicated to improving the lives we touch through the delivery of high-quality care and exceptional service. As a leading provider in the long-term care indus...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
  • serp_jobs.job_card.promoted
Manager, Clinical Risk (Hybrid role, RN Required) (Franconia)

Manager, Clinical Risk (Hybrid role, RN Required) (Franconia)

Mary Washington HealthcareAlexandria, VA, United States
serp_jobs.job_card.full_time
Start the day excited to make a differenceend the day knowing you did.Clinical Risk Manager assists with clinical identification, risk evaluation and coordination of corrective action implementatio...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Clinical Director

Clinical Director

ALPAS WELLNESS LA PLATA LLCSterling, VA, US
serp_jobs.job_card.full_time
At Alpas Wellness Centers, our mission is to provide a safe, inclusive, and forward-thinking environment where people heal their minds and bodies, rediscover their purpose, and forge a path of reco...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
Medical Review Manager

Medical Review Manager

J29, IncMillersville, MD, US
serp_jobs.job_card.full_time
serp_jobs.filters_job_card.quick_apply
This position is contingent upon the successful award of the associated contract.Employment is not guaranteed until the contract is awarded, and the position is officially activated.Job responsibil...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Clinical Manager

Clinical Manager

MedVantaFalls Church, VA, US
serp_jobs.job_card.full_time
This position is ideal for a Certified Athletic Trainer (ATC) looking to advance into leadership or a clinic manager with orthopaedic or musculoskeletal experience who values close collaboration wi...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Senior Manager, Clinical Trials Contracting

Senior Manager, Clinical Trials Contracting

Quest DiagnosticsBaltimore, MD, US
serp_jobs.job_card.full_time
Senior Manager, Clinical Trials Contracting.The Senior Manager, Clinical Trials Contracting is responsible for leading all contracting activities related to clinical trials and research collaborati...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Clinical Risk Manager

Clinical Risk Manager

Mount Sinai HospitalWashington, DC, US
serp_jobs.job_card.full_time
This is the main job post content.Please focus on the core content of the job post.We want to remove any extra metadata, navigation links, and other unnecessary information.The job description, det...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Manager, Clinical Risk (Hybrid role, RN Required) (Manassas)

Manager, Clinical Risk (Hybrid role, RN Required) (Manassas)

Mary Washington HealthcareManassas, VA, United States
serp_jobs.job_card.full_time
Start the day excited to make a differenceend the day knowing you did.Clinical Risk Manager assists with clinical identification, risk evaluation and coordination of corrective action implementatio...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Clinical Office Manager MD

Clinical Office Manager MD

Quadrant IncSilver Spring, Maryland, US
serp_jobs.job_card.full_time
Clinical Manager - Office Manager.Please double check you have the right level of experience and qualifications by reading the full overview of this opportunity below. Experienced Clinical Manager -...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
  • serp_jobs.job_card.promoted
Senior Clinical Risk Manager

Senior Clinical Risk Manager

Mount Sinai HospitalWashington, DC, US
serp_jobs.job_card.full_time
The Senior Clinical Risk Manager serves as a resource to staff to enhance patient safety, promote quality of care, and minimize loss to protect the assets of the facility.The Senior Risk Manager su...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
RN Director

RN Director

BrightSpring Health ServicesArlington, VA, US
serp_jobs.job_card.full_time
RN Director Home Health Clinical Practice.Provide oversight, leadership and support relating to clinical practice and care provision. Consult and collaborate with agency leadership and nursing to ac...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
Clinical Manager (Licensed OT / PT / SLP)

Clinical Manager (Licensed OT / PT / SLP)

Premier Pediatric Therapy SourceAnnandale, Virginia, United States
serp_jobs.job_card.full_time
serp_jobs.filters_job_card.quick_apply
Shape Programs, Mentor Clinicians, Change Lives.Step into a role where your leadership directly improves care for children across the DMV. We’re looking for a licensed clinical leader who loves ment...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
  • serp_jobs.job_card.promoted
Manager, Clinical Risk (Hybrid role, RN Required)

Manager, Clinical Risk (Hybrid role, RN Required)

Mary Washington HealthcareFranconia, VA, US
serp_jobs.job_card.full_time
Start the day excited to make a difference…end the day knowing you did.Clinical Risk Manager assists with clinical identification, risk evaluation and coordination of corrective action implementati...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Clinical Trials Manager

Clinical Trials Manager

Georgetown UniversityWashington, DC, US
serp_jobs.job_card.full_time +1
Georgetown University comprises two unique campuses in the nation's capital.With the Hilltop Campus located in the heart of the historic Georgetown neighborhood, and the Capitol Campus, just minute...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
  • serp_jobs.job_card.promoted
Clinical Manager - Office Manager

Clinical Manager - Office Manager

QuadrantChevy Chase, MD, US
serp_jobs.job_card.full_time
Clinical Manager - Office Manager Chevy Chase, Maryland.MUST : Experienced Clinical Manager - Office Manager 4 plus years of experience as a Clinical Manager - Office Manager within Healthcare 3 plu...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
Clinical Manager – Behavioral Health

Clinical Manager – Behavioral Health

Community Wellness Ventures LLCWashington, DC, US
serp_jobs.job_card.full_time
serp_jobs.filters_job_card.quick_apply
Clinical Manager – Behavioral Health Community Wellness Ventures – Washington, DC Community Wellness Ventures is seeking an experienced Clinical Manager to oversee client care and provi...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
Nurse, Clinical Medical Reviewer

Nurse, Clinical Medical Reviewer

KMM Technologies, Inc.Baltimore, MD, United States
serp_jobs.job_card.full_time
serp_jobs.filters_job_card.quick_apply
Position : Nurse, Clinical Medical Review Location : Baltimore, MD #HYBRID Duration : 6months #C2H Rate : $35 / hr &l...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days