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Vaya HealthNew
Overview
The IDD UM Care Reviewer facilitates the review of service plans and authorization requests to ensure appropriate service delivery for individuals. This includes screening requests for completeness, approving based on check-sheets, and referring complex cases to clinicians.
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Compensation
$50,007 - $65,009 / YEAR
Posted
New
Molina Healthcare
Responsible for verifying that clinical services are medically necessary and align with established guidelines and insurance policies. The role involves analyzing service requests, processing prior authorizations, and collaborating with multidisciplinary teams to ensure cost-effective member care.
$24 - $51 / HOUR
10 days ago
Conducts clinical service reviews for behavioral health members to ensure medical necessity and compliance with guidelines. Collaborates with multidisciplinary teams to manage care outcomes and process prior authorizations within required timelines.
$26 - $51 / HOUR
17 days ago
MultiCare Health System
The Respiratory Care Practitioner is responsible for delivering skilled respiratory care modalities and interventions to patients with cardiopulmonary system deficiencies. This includes performing independent respiratory care, ventilator management, and clinical evaluations.
$36 - $55 / HOUR
27 days ago
The clinician is responsible for assessing service requests to ensure medical necessity, cost-effectiveness, and compliance with clinical guidelines and regulations. They collaborate with multidisciplinary teams and medical directors to facilitate appropriate care outcomes for members.
Salary not listed
1 month ago
The clinician is responsible for conducting clinical service reviews to ensure medical necessity and compliance with behavioral health guidelines. They collaborate with multidisciplinary teams and providers to manage member care and facilitate appropriate treatment authorizations.
The clinician assesses service requests for medical necessity and compliance with clinical guidelines to ensure cost-effective member care. They collaborate with multidisciplinary teams and medical directors to manage prior authorizations and support the integrated delivery of care.
Liquid Personnel
Conduct in-depth manual handling assessments and review existing care packages. Identify opportunities to reduce care dependency through safe, person-centred interventions.
£35 / HOUR
Kaiser Permanente
The primary responsibility involves conducting telephonic medical necessity reviews for designated Home Care and DME Specialty Care services using established criteria and guidelines. This role also includes performing eligibility and benefit reviews, identifying patients for case management, and communicating with various internal and external stakeholders.
3 months ago
