Florida Licensed Care Review Clinician

Job Summary

A company is looking for a Care Review Clinician to provide support for clinical member services review assessment processes.

Key Responsibilities

• Assess services for members to ensure optimum outcomes and compliance with regulations
• Analyze clinical service requests against evidence-based clinical guidelines
• Conduct reviews for prior authorization and collaborate with multidisciplinary teams

Required Qualifications

• At least 2 years of healthcare experience in relevant areas
• Clinical licensure and/or certification as required by state regulations
• Ability to prioritize and manage multiple deadlines
• Proficiency in Microsoft Office suite or applicable software programs