Description:
Position Summary:
Provide comprehensive healthcare management services to facilitate appropriate healthcare treatment, effectively manage healthcare costs and improve healthcare program/operational efficiency involving clinical issues
Duties:
Determines medical necessity/ appropriateness
Facilitates optimal outcomes
Identifies and follow through with continuous quality/ compliance opportunities . May also include identification of aberrance's and initiation of corrective action
Educates/ empowers customers to ensure compliance, satisfaction and promote patient advocacy
Optimize total costs
Implementation and evaluation of policy based on usage and program directives
Educate/empower colleagues at all levels to enable decision making at most appropriate level
Experience :
Minimum 3 years of relevant experience
Education:
Bachelor's or Master's degree in Social Work with license in Social Work
Notes:
Mon-Fri 8a-5p
Job ID: 493341752
Originally Posted on: 9/16/2025
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