INITIAL CLINICAL REVIEWER – Phoenix, AZ

Picture Yourself With An Industry Leader

National Imaging Associates, Inc. (NIA), a subsidiary of Magellan Health Services, is the nation?s largest radiology benefits management company, offering the widest array of innovative solutions available. Serving more than 14 million health plan members in 36 states, we seek an Initial Clinical Reviewer for our location in Phoenix, AZ.

In this first-level capacity, you will evaluate all cases that do not initially pass the authorization approval process, while promoting a supportive team approach among call center staff. To ensure your success, peer clinical review staff MDs will provide invaluable support throughout the utilization management determination process.

Your responsibilities will include:
? Approving all services that meet clinical review criteria.
? Referring cases that do not meet criteria for further review.
? Working with personnel to obtain relevant clinical history/information, providing notification of approvals/denials and giving clinical rationale.
? Providing optimum customer service through professional & accurate communication and adhering to NCQA & health plan?s timeframe.
? Documenting all communication with medical office staff and/or MD provider.
? Practicing the principles of utilization management according to NIA policies and procedures.
? Participating in ongoing training programs to ensure quality performance.

Requirements:
? Bachelor?s degree or equivalent work experience.
? Current AZ licensed RN or LVN.
? A minimum of 5 years clinical experience; 1 year managed care experience preferred.
? Excellent interpersonal and communication skills.
? Basic proficiency with PCs and common office software.
? Knowledge of outpatient imaging procedures preferred.

We offer a competitive salary & excellent benefits. To apply, please E-mail or fax your resume with salary history to, E-mail: tholub@niainc.com ; Fax: 916-852-2643 EOE mfdv

National Imaging Associates, Inc.
www.niainc.com