Virginia Licensed Clinical Reviewer

A company is looking for a Lead Clinical Reviewer.

Key Responsibilities

Review medical records against criteria to determine medical appropriateness

Guide team members and support training and documentation efforts

Perform quality monitoring and audits to identify areas for improvement

Required Qualifications

Active and unrestricted Licensed Clinical Social Worker (LCSW) license for the state of Virginia

Master's degree from an accredited college in a relevant degree program

2+ years of experience in Prior Authorization, Utilization Review (UR), or Utilization Management (UM)