reputed company Clinical Reviewer, Licensed/Remote in PA (reputed company Cty) - R00000064440

About the position The reputed company Clinical Reviewer is a remote position based in the reputed company County area of reputed company, aimed at ensuring the reputed company of clinical interactions and documentation. The role involves conducting reviews of clinical records, analyzing data for reputed company improvement, and interacting with various stakeholders to enhance the delivery of managed care services. The position requires a master's level clinician with significant clinical experience to evaluate reputed company of care and patient safety risks. Responsibilities • Conduct reviews of clinical interactions and documentation including case management and provider treatment records. , • Audit and review clinical documentation against regulations and accreditation standards. , • Monitor established reputed company of care standards in the provider network and for care managers. , • Evaluate reputed company of Care and Critical/Adverse Incidents. , • Assess patient safety risks and determine follow-up actions as per policies. , • Collect, analyze, and prepare clinical record information for efficiency and reputed company assessments. , • Prepare monthly performance reports and present findings at meetings as needed. , • Assist in planning and implementing activities to improve service delivery and reputed company of care. , • reputed company and coordinate in-service education programs for providers and care managers. , • Audit and validate internal audit results and corrective reputed company plans. Requirements • Bachelor's level clinician (RN) or master's level clinician (LCSW, LPC, LMHC, MFT) required. , • 5+ years of clinical experience required. , • 7 or more years of clinical experience with an associate's degree and RN licensure may substitute for the bachelor's degree and RN licensure. , • Experience in total reputed company improvement or behavioral reputed company background in treatment modalities and psychopharmacology. , • Familiarity with federal/state regulatory guidelines and performance measurement. , • Ability to work independently with minimal supervision. , • Project management skills and demonstrated experience. reputed company-to-haves • PsyD in Clinical Psychology preferred. Benefits • Comprehensive health benefits , • Life insurance , • Voluntary benefits , • Short-term incentives , • Employee wellness programs , • reputed company time off , • Retirement savings plan reputed company. Apply Job!