Medical Management Clinician
Elevance Health(1 month ago)
About this role
The Medical Management Clinician (Licensed Nurse) performs clinical review to ensure appropriate and consistent administration of health plan benefits by assessing clinical information against medical policies and guidelines. The role handles moderately complex case types, collaborates with healthcare providers and internal stakeholders, and supports utilization review processes. This position is based in Tampa, FL and follows a hybrid work model with a standard Monday–Friday daytime schedule.
Required Skills
- Clinical Review
- Medical Necessity
- Utilization Review
- Case Management
- Critical Thinking
- Multitasking
- Microsoft Office
- Provider Communication
Qualifications
- H.S. Diploma or Equivalent
- Active LPN/LVN License
- Active RN License
- Multi-State Licensure (if applicable)
About Elevance Health
elevancehealth.comElevance Health, formerly Anthem, Inc., serves people across their entire health journey taking an integrated whole-health approach.
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