Talent.com
serp_jobs.error_messages.no_longer_accepting
Tennessee Licensed Clinical Review Manager

Tennessee Licensed Clinical Review Manager

VirtualVocationsMontgomery, Alabama, United States
job_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

Licensed Clinical Manager • Montgomery, Alabama, United States

Job_description.internal_linking.related_jobs
  • serp_jobs.job_card.promoted
Illinois Licensed Clinical Counselor

Illinois Licensed Clinical Counselor

VirtualVocationsMontgomery, Alabama, United States
serp_jobs.job_card.full_time
A company is looking for a Licensed Clinical Professional Counselor (LCPC) to provide outpatient services through a telehealth program. Key Responsibilities Provide outpatient mental health servic...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Associate Director, Clinical Data Management

Associate Director, Clinical Data Management

VirtualVocationsMontgomery, Alabama, United States
serp_jobs.job_card.full_time
A company is looking for an Associate Director, Clinical Data Management.Key Responsibilities Oversee clinical data management activities for multiple studies, including eCRF development, data cl...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
HEDIS Reviewer

HEDIS Reviewer

VirtualVocationsMontgomery, Alabama, United States
serp_jobs.job_card.full_time
A company is looking for a HEDIS Reviewer.Key Responsibilities Audit information entered into the software system for abstraction, overreading, and data entry Maintain project productivity level...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
Licensed Behavioral Care Advocate

Licensed Behavioral Care Advocate

VirtualVocationsMontgomery, Alabama, United States
serp_jobs.job_card.full_time
A company is looking for a Utilization Management Behavioral Care Advocate - Remote.Key Responsibilities Perform utilization management and review of behavioral health admissions and continued st...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Travel Nurse RN - Telemetry - $1,724 per week in Birmingham, AL

Travel Nurse RN - Telemetry - $1,724 per week in Birmingham, AL

TravelNurseSourceMontgomery, Alabama, US
serp_jobs.job_card.full_time
TravelNurseSource is working with Magnet Medical to find a qualified Telemetry RN in Birmingham, Alabama, 35201!.Purpose of the Position : Responsible for the delivery of direct patient care using t...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
State Licensed Clinical Executive

State Licensed Clinical Executive

VirtualVocationsMontgomery, Alabama, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Executive to join their Client Success team.Key Responsibilities Provide clinical expertise and guidance to clients on product strategy and healthcare best pra...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
South Carolina Licensed Senior Medical Director

South Carolina Licensed Senior Medical Director

VirtualVocationsMontgomery, Alabama, United States
serp_jobs.job_card.full_time
A company is looking for a Senior Medical Director to oversee medical review strategies and collaborate with stakeholders. Key Responsibilities Oversee the development and implementation of Medica...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
Pennsylvania Licensed Precert Care Manager

Pennsylvania Licensed Precert Care Manager

VirtualVocationsMontgomery, Alabama, United States
serp_jobs.job_card.full_time
A company is looking for a Precert Care Manager for the overnight shift.Key Responsibilities Complete acute and non-ambulatory precertifications and apply medical necessity guidelines Consult wi...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
Revenue Cycle Liaison

Revenue Cycle Liaison

VirtualVocationsMontgomery, Alabama, United States
serp_jobs.job_card.full_time
A company is looking for a Revenue Quality Liaison.Key Responsibilities Analyze patterns and trends for avoidable write-offs focused on clinical workflows Conduct root cause analysis and propose...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
Senior Coordinator, Appeals Management

Senior Coordinator, Appeals Management

VirtualVocationsMontgomery, Alabama, United States
serp_jobs.job_card.full_time
A company is looking for a Senior Coordinator, Complaint and Appeals (Remote, PST).Key Responsibilities Oversee investigations and resolutions of appeals, ensuring timely and customer-focused res...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
Tennessee Licensed Appeals Coordinator

Tennessee Licensed Appeals Coordinator

VirtualVocationsMontgomery, Alabama, United States
serp_jobs.job_card.full_time
A company is looking for an Appeals and Letters Coordinator remote position.Key Responsibilities : Process denial-related and member-oriented written communications in compliance with Federal and ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
  • serp_jobs.job_card.promoted
Remote Medical Coding Reviewer

Remote Medical Coding Reviewer

VirtualVocationsMontgomery, Alabama, United States
serp_jobs.filters.remote
serp_jobs.job_card.full_time
A company is looking for a Medical Coding Reviewer I.Key Responsibilities Perform clinical / coding medical claim review to ensure compliance with coding practices Analyze provider billing practic...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Ohio Licensed Therapist

Ohio Licensed Therapist

VirtualVocationsMontgomery, Alabama, United States
serp_jobs.job_card.part_time
A company is looking for a Therapist - Adult IOP (Part-time / Remote).Key Responsibilities Oversee a caseload of clients, ensuring comprehensive delivery of individual and family therapy Co-facili...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
California Licensed Senior Resolution Manager

California Licensed Senior Resolution Manager

VirtualVocationsMontgomery, Alabama, United States
serp_jobs.job_card.full_time
A company is looking for a Senior Resolution Manager to oversee claims management and resolution processes.Key Responsibilities Execute decision-making to analyze and resolve claims effectively ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
Licensed Senior Resolution Manager

Licensed Senior Resolution Manager

VirtualVocationsMontgomery, Alabama, United States
serp_jobs.job_card.full_time
A company is looking for a Senior Resolution Manager to oversee claims management and resolution processes.Key Responsibilities Analyze claims exposure and execute decision-making to resolve clai...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
Medical Review Contractor

Medical Review Contractor

VirtualVocationsMontgomery, Alabama, United States
serp_jobs.job_card.full_time
A company is looking for a Medical Review Contractor to serve as a liaison to cross-functional teams and incorporate current medical information into departmental resources.Key Responsibilities P...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
  • serp_jobs.job_card.promoted
Licensed Client Service Manager

Licensed Client Service Manager

VirtualVocationsMontgomery, Alabama, United States
serp_jobs.job_card.full_time
A company is looking for a Remote Client Service Manager to deliver exceptional customer service and manage client relationships. Key Responsibilities Lead the renewal process to provide high-qual...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
Licensed Patient Programs Specialist

Licensed Patient Programs Specialist

VirtualVocationsMontgomery, Alabama, United States
serp_jobs.job_card.full_time
A company is looking for a Patient Programs Specialist (Remote).Key Responsibilities Support management of complex and high-risk clinical situations for providers and patients Investigate clinic...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
North Carolina Licensed Utilization Management Nurse

North Carolina Licensed Utilization Management Nurse

VirtualVocationsMontgomery, Alabama, United States
serp_jobs.job_card.full_time
A company is looking for a Utilization Management Nurse.Key Responsibilities Performs clinical utilization reviews using evidence-based guidelines and internal policies Collaborates with healthc...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
Pennsylvania Licensed RN Care Navigator

Pennsylvania Licensed RN Care Navigator

VirtualVocationsMontgomery, Alabama, United States
serp_jobs.job_card.full_time
A company is looking for an RN Care Navigator in Pennsylvania.Key Responsibilities Manage case management specific to kidney health, including member data entry and care plan maintenance Educate...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours