Talent.com
Multi-State Licensed Care Review Clinician
Multi-State Licensed Care Review ClinicianVirtualVocations • Newark, New Jersey, United States
Multi-State Licensed Care Review Clinician

Multi-State Licensed Care Review Clinician

VirtualVocations • Newark, New Jersey, United States
Hace 6 días
Tipo de contrato
  • A tiempo completo
Descripción del trabajo

A company is looking for a Care Review Clinician (LVN / LPN).

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, including inpatient review or managed care

Active and unrestricted clinical licensure / certification as required by state regulations

Ability to prioritize and manage multiple deadlines

Experience in hospital acute care or prior authorization is preferred

Multi-state or compact licensure is preferred for specific states

Crear una alerta de empleo para esta búsqueda

Licensed Clinician • Newark, New Jersey, United States

Ofertas relacionadas
New York Licensed Clinical Reviewer

New York Licensed Clinical Reviewer

VirtualVocations • Hamilton, New Jersey, United States
A tiempo completo
A company is looking for a Clinical Review Clinician - Appeals.Key Responsibilities Performs clinical reviews to resolve and process appeals by analyzing medical records and clinical data Ensure...Mostrar más
Última actualización: hace más de 30 días • Oferta promocionada
Multi-State Licensed Care Review Clinician

Multi-State Licensed Care Review Clinician

VirtualVocations • New York, New York, United States
A tiempo completo
A company is looking for a Care Review Clinician (LVN / LPN).Key Responsibilities Assess services for members to ensure optimum outcomes and compliance with regulations Analyze clinical service ...Mostrar más
Última actualización: hace 6 días • Oferta promocionada
State Licensed Utilization Review Nurse

State Licensed Utilization Review Nurse

VirtualVocations • Hamilton, New Jersey, United States
A tiempo completo
A company is looking for a Utilization Review Nurse - Full-Time.Key Responsibilities Review and evaluate electronic medical records for emergency admissions and assess medical necessity Apply cl...Mostrar más
Última actualización: hace más de 30 días • Oferta promocionada
Texas Licensed Physician Reviewer

Texas Licensed Physician Reviewer

VirtualVocations • Bronx, New York, United States
A tiempo completo
A company is looking for Board Certified Physician Reviewers in Internal Medicine / Allergy & Immunology with a Texas license. Key Responsibilities Review treatment requests and appeals for medical ...Mostrar más
Última actualización: hace 3 días • Oferta promocionada
New York Licensed Clinical Review Nurse

New York Licensed Clinical Review Nurse

VirtualVocations • Bronx, New York, United States
A tiempo completo
A company is looking for a Clinical Review Nurse - Concurrent Review.Key Responsibilities Performs concurrent reviews to evaluate member health and appropriateness of care Reviews quality and co...Mostrar más
Última actualización: hace más de 30 días • Oferta promocionada
Licensed Clinical Review Nurse

Licensed Clinical Review Nurse

VirtualVocations • Yonkers, New York, United States
A tiempo completo
A company is looking for a Clinical Review Nurse - Concurrent Review.Key Responsibilities Performs concurrent reviews to determine overall health and appropriate level of care for members Review...Mostrar más
Última actualización: hace más de 30 días • Oferta promocionada
Patient Programs Specialist

Patient Programs Specialist

VirtualVocations • Paterson, New Jersey, United States
A tiempo completo
A company is looking for a Specialist, Patient Programs.Key Responsibilities Provide patient outreach via outbound phone calls to new and existing Specialty Pharmacy patients Communicate with do...Mostrar más
Última actualización: hace 3 días • Oferta promocionada
Clinical Review Nurse

Clinical Review Nurse

AmTrust Financial • Princeton, NJ, United States
A tiempo completo
US-NY-Latham | US-NJ-Princeton | US-NH-Nashua.AmTrust Financial Services, a fast-growing commercial insurance company, has a need for Clinical Review Nurse remote or in an office.The Clinical Revie...Mostrar más
Última actualización: hace 17 días • Oferta promocionada
Indiana Licensed Clinical Review Nurse

Indiana Licensed Clinical Review Nurse

VirtualVocations • New York, New York, United States
A tiempo completo
A company is looking for a Clinical Review Nurse - Concurrent Review.Key Responsibilities Perform concurrent reviews to determine member's overall health and appropriate level of care Review qua...Mostrar más
Última actualización: hace 5 días • Oferta promocionada
Registered Nurse Medicaid Reviewer

Registered Nurse Medicaid Reviewer

VirtualVocations • New York, New York, United States
A tiempo completo
A company is looking for a Medicaid Medical Review Subject Matter Expert.Key Responsibilities Collaborate with Data Analysis and Program Integrity teams to conduct proactive studies meeting CMS r...Mostrar más
Última actualización: hace 5 días • Oferta promocionada
New Jersey Licensed Clinical Navigator

New Jersey Licensed Clinical Navigator

VirtualVocations • Astoria, New York, United States
A tiempo completo
A company is looking for a Clinical Navigator - Cardiovascular - RN.Key Responsibilities Serves as a single point of contact for referring physicians, patients, and caregivers to provide resource...Mostrar más
Última actualización: hace 1 día • Oferta promocionada
Multi-State Licensed Review Nurse

Multi-State Licensed Review Nurse

VirtualVocations • Paterson, New Jersey, United States
A tiempo completo
A company is looking for a Preservice Review Nurse RN - Remote.Key Responsibilities Perform pre-service clinical coverage review of outpatient services Review and interpret clinical / medical reco...Mostrar más
Última actualización: hace más de 30 días • Oferta promocionada
Minnesota Licensed Utilization Review Nurse

Minnesota Licensed Utilization Review Nurse

VirtualVocations • Astoria, New York, United States
A tiempo completo
A company is looking for a Utilization Review Nurse responsible for managing pre-claim prior authorization denials for pharmacy and medical benefits. Key Responsibilities Review and assess prior a...Mostrar más
Última actualización: hace 1 día • Oferta promocionada
DC Licensed Utilization Nurse Reviewer

DC Licensed Utilization Nurse Reviewer

VirtualVocations • Hamilton, New Jersey, United States
A tiempo completo
A company is looking for a Utilization Nurse Reviewer (Remote).Key Responsibilities Conduct timely clinical chart reviews and communicate effectively with third-party payers Review admission ser...Mostrar más
Última actualización: hace 5 días • Oferta promocionada
Clinical Decision Support Specialist (APN)

Clinical Decision Support Specialist (APN)

healthPrecision / Medical Brain • New York, NY, US
A tiempo completo
Clinical Decision Support Specialist (APN).Full-Time | New York, NY (On-site preferred / Remote).Be part of a fast-paced, cutting-edge healthtech startup revolutionizing clinical decision-making th...Mostrar más
Última actualización: hace más de 30 días • Oferta promocionada
Texas Licensed Care Review Clinician

Texas Licensed Care Review Clinician

VirtualVocations • New York, New York, United States
A tiempo completo
A company is looking for a Care Review Clinician (RN) for Prior Authorization.Key Responsibilities Assess services for members to ensure optimum outcomes and compliance with regulations Analyze ...Mostrar más
Última actualización: hace 5 días • Oferta promocionada
Clinical Reviewer, Grievance & Appeals (Remote)

Clinical Reviewer, Grievance & Appeals (Remote)

EmblemHealth • New York, NY, United States
Teletrabajo
A tiempo completo
Perform clinical and administrative reviews within the Grievance and Appeals department, ensuring accurate administration of benefits, execution of clinical policy, timely access to appropriate lev...Mostrar más
Última actualización: hace 14 días • Oferta promocionada
Hawaii Licensed Utilization Review Clinician

Hawaii Licensed Utilization Review Clinician

VirtualVocations • Astoria, New York, United States
A tiempo completo
A company is looking for a Utilization Review Clinician - Behavioral Health.Key Responsibilities Evaluates treatment for mental health and substance abuse to ensure medical appropriateness Perfo...Mostrar más
Última actualización: hace 1 día • Oferta promocionada