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* Participate in telephonic outreach for collaboration with treating providers. This will include discussion of evidence - based guidelines...
* Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage...
* Participate in telephonic outreach for collaboration with treating providers. This will include discussion of evidence - based guidelines...
* Assists in development and maintaining an efficient UM program to meet the needs of the health plan members and commensurate with company values...
* Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage...
* Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage...
* Develops and maintains a collegial relationship with clinicians to support the business efforts of the organization * Implements market specific...
* Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage...
* Participate in telephonic outreach for collaboration with treating providers. This will include discussion of evidence - based guidelines...
* Ability to build relationships to support and educate IPA providers on the benefits of a value-based care model * Drive IPA clinical performance...
* Participate in telephonic outreach for collaboration with treating providers. This will include discussion of evidence - based guidelines...
* Perform utilization review determinations for oncology populations, and support case and disease management teams to achieve optimal clinical...
* Work to improve quality and promote evidence-based medicine * Provide information on quality and efficiency to doctors, patients and customers...
* Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage...
* Provide consistent high-quality DRG-based clinical reviews within the Optum Enterprise Innovative DRG Clinical Review program and be an excellent...
* Clinical leadership within Optum Serve and reports to the Chief Medical Officer, Community Care Services. They collaborate with the CEO, Community...
* Participate in telephonic outreach for collaboration with treating providers. This will include discussion of evidence - based guidelines...
* Participate in telephonic outreach for collaboration with treating providers. This will include discussion of evidence - based guidelines...
* Participate in telephonic outreach for collaboration with treating providers. This will include discussion of evidence - based guidelines...
* Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage...
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