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Kaiser Permanente
Overview
Collaborate with physicians to optimize quality and efficiency of care for hospitalized members through daily utilization reviews and discharge planning. Coordinate seamless transitions of care by assessing patient needs and communicating with multidisciplinary teams and community agencies.
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Compensation
Salary not listed
Posted
2 days ago
Akido
Review and process prior authorization requests for outpatient services to ensure medical necessity and compliance with health plan requirements. Collaborate with providers and Medical Directors to document clinical determinations and maintain regulatory standards.
$62,400 - $93,600 / YEAR
15 days ago
Western Health Advantage
Perform comprehensive clinical reviews of prior authorization, exception, and appeal requests to ensure safe and compliant medication use. Collaborate with PBM partners and internal teams to support formulary development and maintain regulatory compliance with NCQA and DMHC standards.
$118,000 - $14,000 / YEAR
18 days ago
Collaborate with physicians to optimize quality and efficiency of care through daily utilization reviews and the development of safe discharge plans. Coordinate transitions of care between inpatient facilities and community agencies to ensure seamless patient transitions.
1 month ago
