Clinical Nurse Reviewer RN/LVN
Company: Care Navigators On Demand
Posted on: April 5, 2021
Full time - Care Navigators On Demand - United States Posted On
09/15/2017 Job Information Work Experience 1-3 years City Glendale
State/Province California Zip/Postal Code 91324 Job Description As
one of the fastest growing Independent Physician Associations in
Southern California, our organization offers a fast-paced,
exciting, welcoming and supportive work environment. Opportunities
abound, and enterprising, capable, focused people prosper with us.
We promote teamwork, nurture learning, and encourage advancement
for all of our employees. We want to see you excel, because we
believe that your success is our success.
We currently have an opening for Clinical Nurse Reviewer
The Clinical nurse reviewer will specifically run analysis on this
line of business and review with the Regional Medical Director(s)
high cost prior authorization requests as well as hospital
readmissions. Also responsible for the optimization and integration
of these areas: member services, network management, provider and
member relations, marketing, training/development, resource
management, as it may relate to this product line. Working
collaboratively with the Regional Medical Director to fulfill the
business and medical management needs and initiatives.
Qualifications 1. Minimum of 2 years relevant work experience in a
managed care setting, health plan or large medical group
2. Knowledge of the prior authorization process.
3. Knowledge of contracting principles/tools. (preferred)--
4. Excellent verbal and written communication skills.
5. Proficient in MS Office programs (i.e., Word, Excel, Outlook,
Access and Power Point)
6. Must be able to travel within service area and have valid
driver's license and insurance (preferred)
We offer a full benefits package which includes employer paid
medical, pharmacy and dental benefits. We offer a generous PTO
package, 401k Retirement Savings, Life Insurance, Flexible Spending
Account (FSA), Tuition Reimbursement & Licensed Renewal Fees for
our clinical staff. City:--Glendale Care Navigators On Demand is an
Equal Opportunity Employer and does not discriminate on the basis
of race or ethnicity, religion, sex, national origin, age, veteran
disability or genetic information or any other reason prohibited by
law in employment.
Keywords: Care Navigators On Demand, Glendale , Clinical Nurse Reviewer RN/LVN, Healthcare , Glendale, Arizona
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