Tennessee Licensed Clinical Review Manager
VirtualVocationsHayward, California, United Statesjob_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 • Hayward, California, United States
Job_description.internal_linking.related_jobs
The role of the inpatient case manager is one of patient advocate of appropriate utilization of resources.The inpatient case manager applies the process of assessment, planning, implementation, mon...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
We are so glad you are interested in joining Sutter Health!.Organization : SCAH-Sutter Care at Home - Bay.Position Overview : Successful candidate will have leadership experience in a Home Health env...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Clinical Operations is responsible for the worldwide execution of all Phase I - IV clinical trials across all therapeutic areas.
Clinical Operations play a key role in ensuring all.SOPs, company pol...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Contract to Hire, Onsite, Full-Time.LHH is seeking a Clinical Contracts Manager to join their dynamic client on a contract basis in San Francisco, California.
In this role, you will leverage your ex...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
Cozeva) is a leading provider of healthcare technology solutions aimed at transforming care delivery and payment.Our innovative platform focuses on value-based care, empowering healthcare teams to ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 The RN - Manager - Cardiovascular Services shares 24-hour responsibility and accountability for the management and operation of the Cath Lab, Cardiac Nurse Navigators, and the STEMI / Chest Pain Pro...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days 
First Line Management Position.This position is a first line management position.The incumbent has 12-hour responsibility for the coordination of care for patients and families.In conjunction with ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
These are some of Skilled Wound Care's core values; we are seeking the absolute best people in healthcare to help us change the way that care is delivered.
Skilled Wound Care is looking for a.RN...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day We are so glad you are interested in joining Sutter Health!.Organization : CPMC-California Pacific Med Center Van Ness.Position Overview : Responsible and accountable to develop and coordinate compon...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 
Are you ready to take your career to the next level by joining a global medical device market leader in diabetes care? At Insulet Corporation, we are transforming lives with innovative products tha...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours The role of the inpatient case manager is one of patient advocate of appropriate utilization of resources.The inpatient case manager applies the process of assessment, planning, implementation, mon...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 
West County Health Centers (WCHC).We are a cohesive team of health care providers, support staff and volunteers dedicated to wellness, compassion, affordability and excellence of care.Come and be a...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
We value every voice by caring deeply for every patient and each other.We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking.Together...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
This position can be 100% remote, but must be located in the United States.Dynavax is a commercial-stage biopharmaceutical company developing and commercializing novel vaccines to help protect the ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
About Us : Health Link Home Health & Hospice is a leading provider of home healthcare services in the South Bay Area, specializing in a broad range of medical specialties and patient treatments.As w...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Senior Clinical Sales Training Manager.This position is based in our Campbell, California offices.This position is hybrid & full-time.
Do you want to make a real impact on patients? Imperative C...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 This position is a first line management position.The incumbent has 12-hour responsibility for the coordination of care for patients and families.
In conjunction with the area's Operations Manager o...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 
Clinical Associate Project Manager.Our mission is to improve health equity by expanding access to cancer precision medicine.
We are a diverse team of experts who believe that health equity starts wi...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30)
Bass Surgery Center is hiring a Clinical Manager.Welcome to Bass Surgery Center,.ASC environment committed to producing the highest quality work and experience for patients and their families.Clini...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Our mission is to detect cancer early, when it can be cured.We are working to change the trajectory of cancer mortality and bring stakeholders together to adopt innovative, safe, and effective tech...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
- serp_jobs.job_card.promoted
RN-Case Manager - AS Utilization Managment - Part Time - 8 Hour - Days
John Muir HealthWalnut Creek, CA, United Statesserp_jobs.job_card.part_time
- serp_jobs.job_card.promoted
Clinical Manager, Home Health
Sutter HealthSan Francisco, CA, USserp_jobs.job_card.full_time
Clinical Trials Manager - I
eTeam IncSan Mateo, California, United Statesserp_jobs.job_card.temporary
serp_jobs.filters_job_card.quick_apply
- serp_jobs.job_card.promoted
Clinical Contracts Manager
LHHSan Francisco, CA, USserp_jobs.job_card.full_time
Clinician Success Manager
CozevaSan Ramon, California, United States, 94582serp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
RN - Clinical Manager - Cardiology Services - Full Time - 8 Hour - Days
John Muir HealthWalnut Creek, CA, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Clinical Shift Manager
Seton Medical CenterDaly City, CA, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
RN / LVN Regional Clinical Liaison - Oakland, CA
Skilled Wound CareOakland, CA, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Manager, Accreditation and Licensure
Sutter HealthSan Francisco, CA, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Clinical Services Manager - San Francisco, CA (Field Based)
Insulet CorporationSan Francisco, CA, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
RN - Case Manager - BSN - AS Utilization Management - Full Time - 8 Hour - Days
John Muir HealthWalnut Creek, CA, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
Clinic Manager
West County Health CentersSan Mateo, CA, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Clinical Sales Liaison
ScionHealthSan Leandro, CA, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Clinical Trial Associate II (Contractor)
Dynavax TechnologiesEmeryville, CA, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Clinical Manager - $15,000 Sign on Bonus
Health LinkMilpitas, CA, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Sr Clinical Sales Training Manager
Imperative CareCampbell, CA, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
OR Clinical Shift Manager
Seton Medical CenterDaly City, CA, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Clinical Associate Project Manager
Trial LibrarySan Francisco, CA, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Clinical Manager
Bass Surgery Center (11621)WALNUT CREEK, California, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Senior Clinical Trial Manager # 4398
GrailMenlo Park, CA, USserp_jobs.job_card.full_time