Clinical Reviewer

4 weeks ago


Margate, Florida, United States Centers Plan for Healthy Living Full time

Centers Plan for Healthy Living is a leading Managed Long-Term Care company in New York, dedicated to providing exceptional healthcare experiences for our members and their families.

We are seeking a highly skilled Registered Nurse to join our team as a Utilization Management Clinical Reviewer.

As a Clinical Reviewer, you will work collaboratively with our multidisciplinary team to identify and manage members who require additional care or support in their homes, ensuring they receive the best possible quality of life.

Your primary responsibility will be to assess and process all authorization requests, determining medical necessity to ensure all care services, member education, and preventative interventions are maintained.

To be successful in this role, you will need to possess excellent written and verbal communication skills, be able to meet tight deadlines, and demonstrate strong problem-solving skills.

We offer a dynamic and supportive work environment, where you will have the opportunity to grow and develop your skills as a healthcare professional.

Key Qualifications:

  • Active RN license
  • Excellent written and verbal communication skills
  • Ability to meet tight deadlines
  • Strong problem-solving skills
  • Proficient in Microsoft Office Suite tools

About Us:

Centers Plan for Healthy Living is committed to leveraging the diverse backgrounds, perspectives, and experiences of our workforce to create opportunities for our employees and our business.

We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status, or any other characteristic protected by law.


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