Care Review Clinician
Company: Walker Healthforce
Location: Seattle
Posted on: March 26, 2026
|
|
|
Job Description:
Job Description Care Review Clinician | Remote | Washington |
Contract Walker Healthforce is seeking a Care Review Clinician
minimum 2-4 years of clinical practice to support a Health
Insurance company based out of California . This is a 3-month
contract opportunity. START DATE: 4/13/2026 HOURS/SCHEDULE: Monday
-Friday 8:00-5:00 PST WORKER TYPE: Contract CORE REQUIREMENTS: At
least 3 years previous MCO utilization management prior
authorization experience. Active, unrestricted State Nursing (RN,
LVN, LPN) license in good standing. Experience with NCQA.
ADDITIONAL REQUIREMENTS: Demonstrated ability to communicate,
problem solve, and work effectively with people. Excellent
organizational skill with the ability to manage multiple
priorities. Work independently and handle multiple projects
simultaneously. Knowledge of applicable state, and federal
regulations. In depth knowledge of Interqual and other references
for length of stay and medical necessity determinations. Experience
with NCQA. Ability to take initiative and see tasks to completion.
Computer Literate (Microsoft Office Products). Excellent verbal and
written communication skills. Ability to maintain attendance to
support required quality and quantity of work. Maintain
confidentiality and comply with Health Insurance Portability and
Accountability Act (HIPAA). Skilled at establishing and maintaining
positive and effective work relationships with coworkers, clients,
members, providers and customers JOB RESPONSIBILITIES: Provides
concurrent review and prior authorizations (as needed) according to
policy for members as part of the Utilization Management team.
Identifies appropriate benefits, eligibility, and expected length
of stay for members requesting treatments and/or procedures.
Participates in interdepartmental integration and collaboration to
enhance the continuity of care for members including Behavioral
Health and Long Term Care. Maintains department productivity and
quality measures. Attends regular staff meetings. Assists with
mentoring of new team members. Completes assigned work plan
objectives and projects on a timely basis. Maintains professional
relationships with provider community and internal and external
customers. Conducts self in a professional manner at all times.
Maintains cooperative and effective workplace relationships and
adheres to company Code of Conduct. Consults with and refers cases
to medical directors regularly, as necessary. Complies with
required workplace safety standards WHAT WE OFFER: Competitive
compensation package Weekly pay via Direct Deposit Medical, Dental
& Vision available 401k options WHY WORK WITH WALKER? Access to our
top ranked team of recruiting and placement specialists Continuous,
one-on-one support from a dedicated engagement manager Professional
resume development and interview preparation Contact our Recruiting
Team today to experience the Walker Healthforce difference! ABOUT
US: Walker Healthforce is known as the dominant force of
performance, precision, expertise, and integrity in the healthcare
consulting community! As a certified WMBE, we provide end-to-end
healthcare IT and clinical solutions to hospitals, health systems,
and payer organizations, including Fortune 100 firms nationwide. We
are healthcare experts, we’re custom not commodity and we’ve been
exceeding expectations for nearly 20 years. Join forces with us to
experience unparalleled results today! We are an Equal Opportunity
Employer committed to a culturally diverse workforce. All qualified
applicants will receive consideration for employment without regard
to race, religion, color, age, sex, national origin, sexual
orientation, gender identity, disability status or protected
veteran status.
Keywords: Walker Healthforce, Renton , Care Review Clinician, Healthcare , Seattle, Washington
