Tennessee Licensed Clinical Review Manager

Job Summary

A company is looking for a Clinical Review Manager - LPN.

Key Responsibilities

• Initiate referrals and support care coordination workflows by gathering clinical information
• Perform structured clinical reviews and escalate findings requiring higher-level clinical judgment
• Document all review activities accurately in required UM systems and communicate case status to relevant parties

Required Qualifications

• Licensed Practical Nurse (LPN) with an active license in Tennessee or participating Nurse Licensure Compact state
• 1-2 years of clinical experience required
• Knowledge of community resources, benefits, and service authorization processes
• Familiarity with care management frameworks and regulatory requirements
• High attention to detail for accurate documentation and compliance with regulatory standards