Indiana Licensed Clinical Reviewer
Company: VirtualVocations
Location: Vista
Posted on: May 24, 2025
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Job Description:
A company is looking for a Clinical Reviewer.
Key Responsibilities
Review medical records against criteria, contract requirements, and
regulatory standards
Assess and manage daily workload and queues while ensuring
compliance with quality standards
Act as a liaison for customer service issues and maintain
professional relationships with internal and external
stakeholders
Required Qualifications
Active unrestricted LPN or RN license in Indiana or a Compact
clinical license
5+ years of clinical experience in an acute, behavioral health, or
med-surgical environment
2+ years of experience in Utilization Review/Management (UR/UM) or
Prior Authorization
2+ years of knowledge of medical necessity review and InterQual
criteria or Milliman Care Guidelines (MCG)
Proficient in navigating multiple systems effectively
Keywords: VirtualVocations, Mission Viejo , Indiana Licensed Clinical Reviewer, Healthcare , Vista, California
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