Talent.com
Virginia Licensed Clinical Reviewer

Virginia Licensed Clinical Reviewer

VirtualVocationsSan Jose, California, United States
job_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 • San Jose, California, United States

Job_description.internal_linking.related_jobs
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
Licensed Physical Therapy Reviewer

Licensed Physical Therapy Reviewer

VirtualVocationsSan Francisco, California, United States
serp_jobs.job_card.full_time
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
  • serp_jobs.job_card.promoted
Florida Licensed Clinical Review Nurse

Florida Licensed Clinical Review Nurse

VirtualVocationsSan Jose, California, United States
serp_jobs.job_card.full_time
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
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
TX and GA Licensed Clinical Manager

TX and GA Licensed Clinical Manager

VirtualVocationsOakland, California, United States
serp_jobs.job_card.full_time
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
  • serp_jobs.job_card.promoted
Remote Medical Coding Reviewer

Remote Medical Coding Reviewer

VirtualVocationsFremont, California, 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
  • serp_jobs.job_card.new
Clinical Audit Analyst II - RN Licensed

Clinical Audit Analyst II - RN Licensed

VirtualVocationsSan Jose, California, United States
serp_jobs.job_card.full_time
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
  • serp_jobs.job_card.promoted
Licensed Clinical Manager

Licensed Clinical Manager

VirtualVocationsFremont, California, United States
serp_jobs.job_card.part_time
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
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
Texas Licensed Clinical Abstract RN

Texas Licensed Clinical Abstract RN

VirtualVocationsSan Jose, California, United States
serp_jobs.job_card.full_time
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
  • serp_jobs.job_card.promoted
Georgia Licensed Clinical Policy Manager

Georgia Licensed Clinical Policy Manager

VirtualVocationsSan Jose, California, United States
serp_jobs.job_card.full_time
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
NC Licensed Clinical Services VP

NC Licensed Clinical Services VP

VirtualVocationsSanta Clara, California, United States
serp_jobs.job_card.full_time
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
  • serp_jobs.job_card.promoted
Tennessee and Missouri RN Clinical Review Coordinator

Tennessee and Missouri RN Clinical Review Coordinator

VirtualVocationsSanta Clara, California, United States
serp_jobs.job_card.full_time
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
  • serp_jobs.job_card.promoted
Tennessee Licensed Clinical Review Manager

Tennessee Licensed Clinical Review Manager

VirtualVocationsSanta Clara, California, United States
serp_jobs.job_card.full_time
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_30
  • serp_jobs.job_card.promoted
New Mexico Licensed Urology Reviewer

New Mexico Licensed Urology Reviewer

VirtualVocationsOakland, California, United States
serp_jobs.job_card.full_time
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
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
Virginia Licensed Clinical Reviewer

Virginia Licensed Clinical Reviewer

VirtualVocationsHayward, California, United States
serp_jobs.job_card.full_time
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
  • serp_jobs.job_card.promoted
Texas Licensed Clinical Policy Manager

Texas Licensed Clinical Policy Manager

VirtualVocationsOakland, California, United States
serp_jobs.job_card.full_time
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
  • serp_jobs.job_card.promoted
Virginia Licensed Urology Reviewer

Virginia Licensed Urology Reviewer

VirtualVocationsFremont, California, United States
serp_jobs.job_card.full_time
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
  • serp_jobs.job_card.promoted
Minnesota Licensed Urology Reviewer

Minnesota Licensed Urology Reviewer

VirtualVocationsOakland, California, United States
serp_jobs.job_card.full_time
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
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
Tennessee Licensed Senior Medical Reviewer

Tennessee Licensed Senior Medical Reviewer

VirtualVocationsHayward, California, United States
serp_jobs.job_card.full_time
A company is looking for a Registered Nurse Senior Medical Reviewer (Medicare Part B).Key Responsibilities Lead and provide guidance to staff in specialty programs, medical review, and utilizatio...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_less
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
Remote Clinical Manager (RN)

Remote Clinical Manager (RN)

VirtualVocationsSan Francisco, California, United States
serp_jobs.filters.remote
serp_jobs.job_card.full_time
A company is looking for a Clinical Manager (RN - Remote - SCA).Key Responsibilities Supervise clinical staff and oversee day-to-day operations Monitor quality of care and compliance with polici...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
  • serp_jobs.job_card.promoted
South Carolina Licensed Clinical Assessor

South Carolina Licensed Clinical Assessor

VirtualVocationsFremont, California, United States
serp_jobs.job_card.full_time
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
  • serp_jobs.job_card.promoted
California Licensed Nurse Reviewer

California Licensed Nurse Reviewer

VirtualVocationsOakland, California, United States
serp_jobs.job_card.full_time
A company is looking for a Nurse Itemized Bill Reviewer (IBR Analyst).Key Responsibilities Perform in-depth reviews of medical claims using UB-04 and itemized statements Verify accuracy of itemi...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days