Clinical Programs Specialist

at
Arbicare

Company Description

Arbicare provides services to improve the lives of employees injured on the job through care and compassionate human interaction.

Job Description

  • The Clinical Programs Specialist is responsible for ensuring that UR and Guidance Review cases receive the calls attention required, as well as coordinating with clinical reviewers and ensuring cases move through the operational process appropriately. Duties include:
  • Handling of peer calls as needed:
  • Contacts physician reviewers for availability as needed
  • Schedules peer to peer discussions based on reviewer availability and case due time Transcribes conversations between physicians
  • Builds positive relationships and coordinates with initial and physician reviewers on best practices, revisions, scheduling and availability, etc.
  • Client communications, written and telephonic
  • Understanding and mastery of GRS & UR best practices by client, jurisdiction and URAC standards Works closely with Guidance Review Director, Director of Business Performance Programs, and QA Coordinators to assess and analyze operational procedures and functions
  • Train on URAC and individual state requirements
  • Train on protected health information and confidentiality
  • Helps contract with reviewers to scale the business as required.

Requirements

  • General technology literacy (working within our email, cloud drive, and information system) Strong typing skills preferred
  • Strong written / oral communication skills
  • Ability to build and maintain relationships
  • Critical reading retention