Found Description
Job Description
- Clinical operations across Utilization Management and Care Management, including:
- Reviewing medical documentation and pre-authorization requests
- Conducting concurrent and retrospective reviews
- Managing member care coordination, follow-ups, and clinical documentation
- Voice & Non-Voice
Qualifications
- Active USRN or PHRN license
- With good to excellent English communication skills
- No clinical and BPO experience required but preferred