Advocacy Clinical Review Coordinator I/II/III
Albanyonsitemid
Posted 2w ago · via Workday
About this role
Job Description: Summary: The Advocacy Clinical Review Coordinator investigates member and provider appeals, grievances, and complaints across all lines of business. Using clinical nursing and medical expertise, they will review medical necessity requests, determine appropriateness of care, and expedite cases within established criteria and regulatory requirements. The position collaborates with internal and external partners, including Medical Directors, Sales, Compliance, Vendors, and Legal, to ensure accurate and timely decisions while managing multiple regulatory timeframes.…
Read the full description on Lifetime Workforce Solutions's site →
What we'd score you on
reqspace match rubricFive dimensions, recruiter-grade. Upload your resume and we'll generate a written explanation of where you fit and where the gaps are.
1
Skills match
We compare your skills against the role requirements.
2
Level fit
This role is mid-level. We check your trajectory against it.
3
Domain experience
Your work in the role's domain matters more than your years total. We weight recent and direct experience.
4
Recency
A skill you used last quarter weighs more than one from five years ago. We grade on recency, not lifetime.
5
Location fit
This role is based in Albany. We weight your proximity and willingness to relocate.
Score yourself on this role.
Free · no card · written explanation included
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