State Licensed Clinical Reviewer

Job is Expired

Location: Remote

Compensation: To Be Discussed

Reviewed: Fri, May 30, 2025

Job Category: Healthcare

Employment Status: Permanent

Employer Type: Employer

Career Level: Experienced

Education Level: Some College

Job Summary

A company is looking for a Lead Clinical Reviewer.

Key Responsibilities

Manage clinical cases and assist in coaching and training team members
Evaluate referral appropriateness and make authorization decisions based on medical necessity
Participate in utilization management activities and contribute to quality audits

Required Qualifications

Associate's Degree or Diploma in Nursing/Practical Nursing or equivalent
Registered Nurse/LPN/LVN license in any state or jurisdiction in the U.S
Minimum of 2 years clinical experience in a clinical setting
Expertise in Utilization Management and knowledge of URAC standards
At least 1 year of Utilization Management experience required

COMPLETE JOB DESCRIPTION

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Job is Expired

Company Overview

Company Company Name

Headquarters Headquarters

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Website

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