Licensed Care Review Clinician

Job Summary

A company is looking for a Care Review Clinician.

Key Responsibilities

• Assesses services for members to ensure compliance with regulations and optimal outcomes
• Analyzes clinical service requests against evidence-based clinical guidelines
• Conducts reviews for prior authorization and collaborates 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/applicable software programs