Summary of Position Direct supervision of the Clinical Nurse Reviewer staff, oversee the clinical team...
options and contributes to the development of a safe member centered service plan Consult with supervisor... that affect member eligibility. Coordinates with other departments, e.g. Care Management, Legal Affairs, Grievance and Appeals...
Consult with supervisor and others in overcoming barriers in meeting goals and objectives. Maintains current knowledge... Affairs, Grievance and Appeals, Compliance, Membership Eligibility Unit, Quality as needed. Participates in requests for out...
options and contributes to the development of a safe member centered service plan Consult with supervisor... that affect member eligibility. Coordinates with other departments, e.g. Care Management, Legal Affairs, Grievance and Appeals...