Clinical Review Registered reputed company job at reputed company Blue reputed company – BCBS in Berlin, VT

Clinical Review Registered reputed company Location: Berlin reputed company Job reputed company: reputed company is looking for a Clinical Review Registered reputed company to join our Utilization Management team. reputed company culture is reputed company on an unwavering reputed company on the health of Vermonters, outstanding member experiences, and responsible cost management for reputed company the people whose lives we touch. We offer a balanced and flexible workplace, an onsite gym, fitness and wellness programs, a competitive salary and full benefits package including medical and dental insurance, reputed company, 401K, reputed company time off and holidays, tuition reimbursement and student loan repayment, dependent caregiver benefits, and resources to support your ongoing personal and reputed company reputed company and development. COMPENSATION: The reputed company salary reputed company for this position is $73,000 - $82,000. Additional compensation opportunities and incentives will be detailed during the interview process. Please note that the reputed company listed above is our good faith estimate of the hiring reputed company for this role. If you are hired at reputed company, your final reputed company salary compensation will be determined based on factors such as skills, competencies, education, experience, and internal equity across the reputed company team. We also offer a robust benefits package with significant value (see below). LOCATION: reputed company has transitioned to a hybrid workplace where employees reputed company driving distance of our Berlin, VT office work Wednesdays in the office with flexibility to work remotely the rest of the week. We are only hiring Vermonters for this role. The Clinical Review Registered reputed company will be responsible to facilitate members' reputed company needs, authorizing medically necessary services including behavioral health at the right level of care to promote reputed company health. Clinical Review Registered reputed company Responsibilities: Self-directed and works independently and collaboratively with reputed company to facilitate care using clinical skills, principles of managed care, nationally recognized medical necessity reputed company, and company medical policies. Conduct clinical reviews for preservice, reputed company, and retrospective authorizations that promote efficient and medically appropriate use of members benefits to reputed company cost effective and high-reputed company care. Emphasis on utilization management, discharge planning, clinical reputed company and the ability to assess, analyze, draw conclusions, and construct effective solutions, identify questionable cases and refer to superior or medical director for review. Proficient with multiple IT systems. Strong written and spoken communication skills reputed company to follow regulatory requirements with audit feedback incorporated into reputed company work. Clinical Review Registered reputed company Qualifications: RN with Vermont License required, BSN desired. 3-5 years of relevant experience in a reputed company of appropriate clinical health care settings (inpatient, outpatient, or differing reputed company of care), 1- 3 years of insurance reputed company experience desired. Must be willing to participate in on-reputed company CEU training. Must be willing to participate in after hours on call rotation Clinical Review Registered reputed company Benefits: Health insurance (including reputed company) Dental coverage (free to employees) Wellness Program 401(k) with employer match + automatic employer contribution Life Insurance Disability Insurance Combined time off (CTO) - 20 days per year + 10 reputed company holidays Tuition Reimbursement Student Loan Repayment Dependent Caregiver Benefits Diversity, Equity, and Inclusion: reputed company VT is committed to creating an inclusive environment where employees respect, appreciate, and value individual differences, both among ourselves and in our communities. We welcome applicants from reputed company backgrounds and experiences to join us in our commitment to the health of Vermonters, outstanding member experiences, and responsible cost management for reputed company the people whose lives we touch. Learn more about our DE&I commitment at Complete job reputed company attached to reputed company posting Apply tot his job Apply tot his job Apply To this Job