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Licensed Clinical Letter Writer
A company is looking for a Clinical Letter Writer with UM & Specialty Experience. Key Responsibilities Review adverse determinations against criteria and medical policies Create adverse determination notifications that meet accreditation, State, and Federal criteria Collaborate with internal and external staff to ensure clear communication of decisions Required Qualifications Licensed registered nurse or LVN/LPN (current and unrestricted) Minimum of three years of direct clinical patient care Minimum one year of experience with Utilization Review (UM) in a managed care environment Cardiology and Oncology healthcare experience/knowledge Experience with clinical decision-making criteria sets (e.g., Milliman, InterQual)
A company is looking for a Clinical Letter Writer with UM & Specialty Experience.
Key Responsibilities
Review adverse determinations against criteria and medical policies
Create adverse determination notifications that meet accreditation, State, and Federal criteria
Collaborate with internal and external staff to ensure clear communication of decisions
Required Qualifications
Licensed registered nurse or LVN/LPN (current and unrestricted)
Minimum of three years of direct clinical patient care
Minimum one year of experience with Utilization Review (UM) in a managed care environment
Cardiology and Oncology healthcare experience/knowledge
Experience with clinical decision-making criteria sets (e.g., Milliman, InterQual)