Clinical Specialist Lpn Jobs in Oregon

Experience in researching evidence-based and industry standards and requirements relevant to medical management programs.

Knowledge of regulatory requirements for Utilization Management including URAC, NCQA, Act 68, ERISA, DOH, HIPAA and CMS.

Minimum of two (2) to three (3) years of managed care experience, specifically in utilization management and/or case management.

Strong team skills with the ability to work and interact with management level staff both within and outside of Clinical Management.

Knowledge of current and emerging medical treatment modalities with the ability to analyze and interpret medical and benefit coverage interrelationships.

Knowledge of managed care principles and emerging health treatment modalities.