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Clinical Reviewer - On Call

Company: Qualis Health
Location: Anchorage
Posted on: April 14, 2019

Job Description:

Job Description

Typical duties and responsibilities include:

* Apply clinical review criteria, guidelines, and screens to determine the medical necessity of health care services.

* Consult with physician/practitioner consultants when reviews fail clinical review criteria, guidelines, and screens.

* Refer cases to others, when indicated.

* As appropriate, provide daily oversight and monitoring of non-clinical staff during their performance of non-clinical support activities; also provide the supervisor with input regarding employees' performance of these activities.

* Provide clinical and/or review process subject matter expertise; respond to customer questions or concerns.

* May perform quality assurance audits and other program support, as assigned.

Work must be performed Monday-Friday during regular business hours
Required Skills

* 3+ years of clinical (direct patient care) experience.

* 1+ years of utilization review (or other medical management experience) preferred.

Required Experience

* BA/BS in a related field.

* MA/MS in psychology, counseling or social work required.

* Current, active, unrestricted clinical licensure as required by the contract being supported.

* Behavioral health licensure options include LCSW, LPA, LPC, PSY D, PH D

.

Qualis Health is an Equal Employment Opportunity/Affirmative Action Employer that embraces and practices diversity, reflecting the communities we serve. We encourage minorities, protected veterans and individuals with disabilities to apply.

Keywords: Qualis Health, Anchorage , Clinical Reviewer - On Call, Healthcare , Anchorage, Alaska

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