Clinical Review Manager FEP
BlueCross BlueShield of Tennessee(1 month ago)
About this role
A Clinical Review Nurse supporting the Federal Employee Program (FEP) at BlueCross BlueShield of Tennessee, focused on clinical oversight for health coverage provided to federal employees, retirees, and their families. The role leverages nursing expertise and clinical judgment to uphold clinical standards, support program compliance, and collaborate with medical leadership.
Required Skills
- Clinical Judgment
- Utilization Management
- Appeals Management
- Medical Coding
- Care Coordination
- Medical Review
- Microsoft Office
- Communication Skills
- Organizational Skills
Qualifications
- Registered Nurse (RN) License
- Nurse Licensure Compact (NLC) Eligibility
About BlueCross BlueShield of Tennessee
bcbst.comLearn more about BlueCross BlueShield of Tennessee (BCBST) health insurance and the medical, dental and vision plans we offer for employers, individuals and families.
View more jobs at BlueCross BlueShield of Tennessee →Apply instantly with AI
Let ApplyBlast auto-apply to jobs like this for you. Save hours on applications and land your dream job faster.
More jobs at BlueCross BlueShield of Tennessee
CHOICES Care Coordinator- Sumner and Robertson Counties
BlueCross BlueShield of Tennessee(4 days ago)
Software Engineer
BlueCross BlueShield of Tennessee(4 days ago)
EIT Engineering Team Lead
BlueCross BlueShield of Tennessee(4 days ago)
EIT Engineering Team Lead
BlueCross BlueShield of Tennessee(5 days ago)
Similar Jobs
Clinical Reviewer - FEP
Blue Cross Blue Shield of Massachusetts(1 month ago)
Medical Review Clinical Appeals Auditor – ALJ (SNF FOCUS)
Performant(2 months ago)
UM Outpatient Clinical Review Nurse, Health New England
Baystate Health(1 month ago)
Clinical Review Specialist
Premera Blue Cross(28 days ago)
LVN - Quality Assurance/Utilization Review - Business Development - Full Time 8hr
Emanate Health(1 year ago)
FEP Performance Specialist (US)
Elevance Health(22 days ago)