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Miami, FL
Must live in Florida Job Summary Provides support for member clinical review processes specific to
…Under minimal supervision, this position is responsible for assisting the Clinical Review Team
Rochester, NY
…necessity criteria, MVP policies, and regulatory guidelines. + Collaborate with Utilization Man
Annapolis, MD
…applicable criteria, and analyzing the basis for the appeal + Ensures timely review , processing
…staff on prescription orders, patient reactions, and errors or complaints. Conducts drug utiliza
…integration and promote best practices in recovery-oriented, trauma-informed care. + Review and
…and analyze program data related to quality outcomes, safety incidents, and service utilization
Hiawatha, IA
…and refinement of transportation services * Assists Transportation/Facility Manager with review
Slidell, LA
…+ Monitor and analyze key performance metrics (eg, report TATs, peer review outcomes, imaging
Boston, MA
…and partner agency. * Facilitate/coordinate return to work - full/modified duty. * Review repor