Clinical Reviewer Lead WA L I

Location: Remote
Compensation: To Be Discussed
Staff Reviewed: Wed, Jul 10, 2024
This job expires in: 27 days

Job Summary

A company is looking for a Clinical Reviewer Lead for a remote position.

Key Responsibilities:
  • Coordinate, delegate, and support the Clinical Review team in assessing medical necessity and quality of healthcare services
  • Review requests for reconsideration, gather additional information, and organize cases for presentation to the National Medical Director
  • Serve as a primary trainer for newly hired clinical reviewers and provide feedback to the manager on progress and concerns

Qualifications:
  • Active RN license in WA or compact State
  • BA/BS in a related field
  • 5 years of clinical experience and 1 year of utilization review or medical management experience
  • Demonstrated understanding of LNI medical treatment guidelines and state Health Technology Assessment decisions
  • Familiarity with client-developed imaging criteria

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