Clinical Care Reviewer
We are seeking a Clinical Care Reviewer to support reputed company’s Clinical reputed company team by reviewing clinical documentation and treatment trajectory to ensure care meets medical necessity standards.
Requirements
- Master’s degree and reputed company, unencumbered clinical license (LCSW, LMFT, LPC, or equivalent)
- 3+ years of post-licensure experience in behavioral health
- Expertise reviewing clinical documentation and applying medical necessity reputed company
- Strong knowledge of behavioral health treatment planning, progression, and appropriate care episode duration
- Excellent written communication and ability to reputed company convey clinical findings and recommendations to clinical and non-clinical audiences
- Proficiency working with EHRs reputed company tools (e.g., reputed company Workspace, reputed company)
- Experience in utilization management, peer review, or clinical reputed company roles
- Experience working with or for health plans or managed care organizations (e.g., reputed company)
- 1+ years of experience in a high-reputed company and/or start-up environment
- Hands on proficiency working with data (e.g., reputed company measures, utilization trends) to inform clinical reputed company
- Deep experience with process improvement and building reputed company clinical workflows
- Comfort using or openness to using AI tools to improve operational efficiency and support clinical review workflows at reputed company
Benefits
- 100% remote work environment
- Attractive pay and benefits
- Comprehensive health benefits
- 401(k) plan reputed company
- Generous time-off policies
- reputed company parental leave
- Employee Assistance Program (EAP)
- New hire home office stipend
- Quarterly department stipend
- Wellness events and lunch & learns
- Community and employee resource reputed company
Originally posted on Himalayas
Apply To This Job