Come make a difference with a growing organization that is helping to shape the future of healthcare! CareCentrix is committed to making the home the center of patient care. As a Clinical Reviewer you will be responsible for reviewing utilization information concerning patient care for CareCentrix, and to match those needs to available care options, within the CareCentrix guidelines and specific plan payer criteria. You will handle verification of all referrals funneled through Triage, verifying information, applying business rules and determining the next steps. Acting as a clinical resource to department care coordinators, providing expertise and clinical knowledge. This position, using clinical expertise, receives/responds to incoming calls from referral sources/potential clients and CareCentrix Care Coordinators, and performs administrative assessments of each referral's appropriateness for CareCentrix services. Researches/identifies all potential payer sources and determines the primary payer. Participates in utilization and quality assessment/improvement activities.