Care Review Clinician (Remote)

Remote: Long Beach, California, US

Salary: $42.00 Per Hour

Job Code: 351821

End Date: 2024-08-17

Job Status: Expired

This Job is no longer accepting applications

Responsibilities:

  • Conduct all Utilization Management standard Inpatient, Outpatient, and Custodial Care clinical reviews for Managed Long Term Care members.
  • Process denials and partial denial determinations.
  • Utilize Milliman Care Guidelines and other computer systems for case presentations and medical reviews.

Must Haves:

  • New York State License Practical Nurse or Registered Nurse.
  • Experience in Utilization Management.
  • Familiarity with Medicaid or Medicare guidelines.
  • Bilingual in Spanish, Bengali, or Mandarin.

Pay range: $40/hr - $42/hr

Job Requirement
  • Utilization Management
  • Milliman Care Guidelines
  • Managed Long Term Care
  • Medicaid
  • Medicare
  • License Practical Nurse
  • Registered Nurse
  • Spanish
  • Bengali
  • or Mandarin
  • Inpatient
  • Outpatient
  • Custodial Care
  • clinical reviews
  • denials
  • partial denial
Reach Out to a Recruiter
  • Recruiter
  • Email
  • Phone
  • Nilofer Charaniya
  • nilofer.charaniya@collabera.com
This Job is no longer accepting applications
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Collabera is a leading global digital talent solutions firm. For over 25 years, we have provided digital and IT talent services, direct placement and career advisement, global remote talent and learning solutions to transform and diversify workforces for the Fortune 1000 globally.

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Collabera is a leading global digital talent solutions firm. For over 25 years, we have provided digital and IT talent services, direct placement and career advisement, global remote talent and learning solutions to transform and diversify workforces for the Fortune 1000 globally.

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