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Elevance Health
Overview
Investigate and process medical necessity appeals requests from members and providers. Prepare recommendations for the Medical Director and ensure all grievances are resolved within regulatory timeframes.
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Compensation
$38 - $57 / HOUR
Posted
12 days ago
Community Health Plan of Washington
The clinician conducts utilization review for medical or behavioral health requests against established guidelines and policies, identifying and coordinating high-quality, cost-effective alternatives for patient care. They ensure members have timely access to care, support transitions between care settings, and collaborate with the healthcare team to achieve optimal patient outcomes.
$74,710 - $115,800 / YEAR
5 months ago
