Licensed Clinical Letter Writer - San Diego California

Company: VirtualVocations
Location: San Diego, California
Posted On: 02/04/2025

A company is looking for a Clinical Letter Writer to support internal and external customers through the creation of regulatory-compliant letters regarding adverse determinations.



Key Responsibilities

Review adverse determinations against criteria and medical policies
Create adverse determination notifications that comply with accreditation, State, and Federal criteria
Communicate adverse decisions clearly to both members and providers using Plain Language


Required Qualifications

Licensed registered nurse or LVN/LPN (current and unrestricted)
Minimum of three years of direct clinical patient care experience
Experience with medical management activities in a managed care environment
Knowledge of cardiology and oncology healthcare
Basic Microsoft Office computer skills More...

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