Talent.com
Virginia Licensed Clinical Reviewer

Virginia Licensed Clinical Reviewer

VirtualVocationsChattanooga, Tennessee, United States
15 hours ago
Job type
  • Full-time
Job description

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)

Create a job alert for this search

Clinical Reviewer • Chattanooga, Tennessee, United States

Related jobs
  • Promoted
Registered Nurse - Clinical Documentation Specialist - Full Time Days

Registered Nurse - Clinical Documentation Specialist - Full Time Days

Williamson HealthNew Hope, TN, US
Full-time
ABOUT WILLIAMSON HEALTH | Williamson Health is a regional healthcare system based in Williamson County, Tennessee, with more than 2,300 employees across more than 30 locations and more than 860 phy...Show moreLast updated: 3 days ago
  • Promoted
  • New!
TX and GA Licensed Clinical Manager

TX and GA Licensed Clinical Manager

VirtualVocationsChattanooga, Tennessee, United States
Full-time
A company is looking for a Manager, Clinical Navigation.Key Responsibilities Lead and develop a team of Clinical Navigators to enhance patient engagement and outcomes Oversee daily operations of...Show moreLast updated: 17 hours ago
  • Promoted
Georgia Licensed Clinical Policy Manager

Georgia Licensed Clinical Policy Manager

VirtualVocationsChattanooga, Tennessee, United States
Full-time
A company is looking for a Manager, Vendor Clinical Policy to join their Clinical Policy team.Key Responsibilities Clinically evaluate vendor policy sets for compliance with medical standards and...Show moreLast updated: 1 day ago
  • Promoted
Licensed Clinical Manager

Licensed Clinical Manager

VirtualVocationsChattanooga, Tennessee, United States
Part-time
A company is looking for a Clinical Manager - Part-Time.Key Responsibilities Report directly to the Director of Therapy and manage a cohort of providers Maintain a clinical caseload and engage i...Show moreLast updated: 1 day ago
  • Promoted
Remote Medical Coding Reviewer

Remote Medical Coding Reviewer

VirtualVocationsChattanooga, Tennessee, United States
Remote
Full-time
A company is looking for a Medical Coding Reviewer I.Key Responsibilities Perform clinical / coding medical claim review to ensure compliance with coding practices Analyze provider billing practic...Show moreLast updated: 30+ days ago
  • Promoted
Virginia Licensed Cancer Registrar

Virginia Licensed Cancer Registrar

VirtualVocationsChattanooga, Tennessee, United States
Full-time
A company is looking for a Cancer Registrar 2 to join the team.Key Responsibilities Analyze medical records to gather demographic data and diagnostic procedures for cancer program accreditation ...Show moreLast updated: 30+ days ago
  • Promoted
  • New!
Texas Licensed Clinical Appeals Coordinator

Texas Licensed Clinical Appeals Coordinator

VirtualVocationsChattanooga, Tennessee, United States
Full-time
A company is looking for a Clinical Appeals Coordinator.Key Responsibilities Act as the liaison for statewide appeals, ensuring compliance with State and NCQA requirements Review clinical inform...Show moreLast updated: 17 hours ago
  • Promoted
Tennessee and Missouri RN Clinical Review Coordinator

Tennessee and Missouri RN Clinical Review Coordinator

VirtualVocationsChattanooga, Tennessee, United States
Full-time
A company is looking for a LOS Clinical Review Coordinator for TN and MO.Key Responsibilities Request and review member's clinical information from providers Perform utilization review of inpati...Show moreLast updated: 1 day ago
  • Promoted
Florida Licensed Clinical Review Nurse

Florida Licensed Clinical Review Nurse

VirtualVocationsChattanooga, Tennessee, United States
Full-time
A company is looking for a Clinical Review Nurse - Concurrent Review.Key Responsibilities Performs concurrent reviews to determine members' overall health and appropriate level of care Reviews q...Show moreLast updated: 30+ days ago
  • Promoted
  • New!
Clinical Audit Analyst II - RN Licensed

Clinical Audit Analyst II - RN Licensed

VirtualVocationsChattanooga, Tennessee, United States
Full-time
A company is looking for a Clinical Government Audit Analyst & Appeal Specialist II (Remote).Key Responsibilities Conduct thorough analyses of denials and ensure accurate coding while identifying...Show moreLast updated: 21 hours ago
  • Promoted
  • New!
Licensed Physical Therapy Reviewer

Licensed Physical Therapy Reviewer

VirtualVocationsChattanooga, Tennessee, United States
Full-time
A company is looking for a Clinical Reviewer, Physical Therapy.Key Responsibilities Evaluate cases that do not pass the authorization approval process and promote a supportive team approach Revi...Show moreLast updated: 21 hours ago
  • Promoted
  • New!
Texas Licensed Clinical Abstract RN

Texas Licensed Clinical Abstract RN

VirtualVocationsChattanooga, Tennessee, United States
Full-time
A company is looking for a Clinical Other - Abstract RN.Key Responsibilities Conduct electronic medical record abstraction services accurately and efficiently Abstract information from electroni...Show moreLast updated: 15 hours ago
  • Promoted
NC Licensed Clinical Services VP

NC Licensed Clinical Services VP

VirtualVocationsChattanooga, Tennessee, United States
Full-time
A company is looking for a VP, Clinical Services to provide leadership and oversight for Clinical Services and Casualty departments. Key Responsibilities Oversee all Clinical Services functions an...Show moreLast updated: 1 day ago
  • Promoted
New Mexico Licensed Urology Reviewer

New Mexico Licensed Urology Reviewer

VirtualVocationsChattanooga, Tennessee, United States
Full-time
A company is looking for Board Certified Physician Reviewers specializing in Urology with a New Mexico License.Key Responsibilities Evaluate medical records and provide clinical summaries Engage...Show moreLast updated: 1 day ago
  • Promoted
Minnesota Licensed Urology Reviewer

Minnesota Licensed Urology Reviewer

VirtualVocationsChattanooga, Tennessee, United States
Full-time
A company is looking for Board Certified Physician Reviewers specializing in Urology with a Minnesota license.Key Responsibilities Evaluate medical records and provide clinical summaries Engage ...Show moreLast updated: 30+ days ago
  • Promoted
Texas Licensed Clinical Policy Manager

Texas Licensed Clinical Policy Manager

VirtualVocationsChattanooga, Tennessee, United States
Full-time
A company is looking for a Manager, Vendor Clinical Policy to join their Clinical Policy team.Key Responsibilities Evaluate vendor policy sets to ensure compliance with internal and external medi...Show moreLast updated: 1 day ago
  • Promoted
California Licensed Nurse Reviewer

California Licensed Nurse Reviewer

VirtualVocationsChattanooga, Tennessee, United States
Full-time
A company is looking for a Nurse Itemized Bill Reviewer (IBR Analyst).Key Responsibilities Perform in-depth reviews of medical claims using UB-04 and itemized statements Verify accuracy of itemi...Show moreLast updated: 2 days ago
  • Promoted
  • New!
Remote Clinical Manager (RN)

Remote Clinical Manager (RN)

VirtualVocationsChattanooga, Tennessee, United States
Remote
Full-time
A company is looking for a Clinical Manager (RN - Remote - SCA).Key Responsibilities Supervise clinical staff and oversee day-to-day operations Monitor quality of care and compliance with polici...Show moreLast updated: 21 hours ago
  • Promoted
South Carolina Licensed Clinical Assessor

South Carolina Licensed Clinical Assessor

VirtualVocationsChattanooga, Tennessee, United States
Full-time
A company is looking for a Clinical Assessor, Mid - RN - Full-time (Remote U.Key Responsibilities Conduct assessments for Medicaid Waiver eligibility using state-approved tools Ensure privacy an...Show moreLast updated: 1 day ago
  • Promoted
  • New!
Licensed Clinical Quality Associate

Licensed Clinical Quality Associate

VirtualVocationsChattanooga, Tennessee, United States
Full-time
A company is looking for a Clinical Quality Associate (Remote).Key Responsibilities Manage the clinical support inbox and respond to inquiries from internal teams, providers, and patients Interp...Show moreLast updated: 15 hours ago