Clinical Review Manager

BlueCross BlueShield of Tennessee(16 days ago)

Tennessee, United States, Chattanooga, TNOnsiteFull TimeSenior$55,000 - $65,000Healthcare / Clinical Operations

About this role

The Clinical Review Manager role involves researching and reviewing clinical information to ensure appropriate member services, coordinating care, and supporting administrative and clinical appeals, all within a fast-paced healthcare setting. The position requires independent work, strong communication skills, and proficiency with clinical and administrative tools.

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Required Skills

Microsoft Office
Clinical Review
Medical Policy
Communication
Organizational Skills
Customer Service
Problem Solving
Appeals Management
Benefits Interpretation
Healthcare Regulations

Qualifications

RN License in Tennessee or Nurse Licensure Compact State
3 years Clinical Experience

About BlueCross BlueShield of Tennessee

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