Team Lead Clinical Reviewer (USRN)

Founded in early 2019 Cadence Rx launched an industry-leading peer-to-peer prescription platform created to elevate our clients experience within the workers compensation market. These goals are achieved through agile responsiveness advanced technology and true transparency. Cadence Rx Inc. is a privately held business based in Tampa Florida. We are a nationally recognized woman-owned business exclusively serving the national workers compensation market. Cadence Rx is an agile and entrepreneurial enterprise led by a dedicated team of industry professionals who share extensive workers compensation knowledge pharmacy expertise and experience in offering a high touch customer service model.

Position Summary :

The Team Lead Clinical Reviewer (US Registered Nurse) plays a key role in overseeing clinical review operations while providing direct clinical recommendations for injured workers. This position ensures that all clinical determinations align with established clinical guidelines regulatory requirements and Cadence Rx procedures. The Team Lead Clinical Reviewer supports workflow management maintains quality and timeliness standards contributes to team development and independently reviews medical histories to make evidence-based clinical recommendations. This role combines hands-on clinical review responsibilities with team leadership process oversight and subject matter expertise.

Roles and Responsibilities :

• Review medical histories and develop evidence-based clinical recommendations consistent with established guidelines and formulary requirements.
• Prepare clear well-written clinical summaries documentation and discussion points to support outreach activities conducted by other team members.
• Maintain up-to-date knowledge of relevant clinical guidelines medication classes adverse effects and therapeutic alternatives.
• Oversee the workflow of clinical review activities ensuring adherence to regulatory client-specific and internal requirements.
• Assign monitor and track clinical review cases to ensure balanced workloads and timely completion of deliverables.
• Ensure accurate documentation and timely submission of all clinical determinations.
• Monitor team productivity quality and compliance metrics and address performance or process issues as needed.
• Serve as a subject matter expert on review processes requirements system workflows and clinical considerations.
• Identify opportunities for process improvements training enhancements and implementation of best practices.
• Provide mentorship coaching and feedback to support team development and performance.
• Participate in audits quality reviews and ongoing compliance monitoring activities.
• Adhere to all company policies procedures and applicable regulatory standards.
• Perform other related duties as assigned.

Qualifications :

All qualified applicants will receive consideration for employment without regard to race color religion gender gender identity sexual orientation national origin ethnicity age disability marital status or any other characteristic protected by law.

Genfinity as an Equal Opportunity Employer believes in each persons potential and well help you achieve yours.

All information will be kept confidential according to EEO guidelines.

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Required Experience :

Manager

Key Skills

Law Enforcement,ABB,Marine Biology,Filing,Automobile,AV

Employment Type : Full-Time

Experience : years

Vacancy : 1