- MetroPlusHealth (New York, NY)
- …what you do every day.The Behavioral Health Utilization Management (BH UM) Clinician is responsible for conducting utilization and quality management activities in ... of medical costs through timely prospective, concurrent, and retrospective review activities. Work Shifts9:00AM-5:00PMDuties & ResponsibilitiesPerforms telephonic review… more
- Centene Corporation (New York, NY)
- …of all appeals requests + Partners with interdepartmental teams to improve clinical appeals processes and procedures to prevent recurrences based on industry ... **Hours: 8:30am-5pm EST Monday - Friday.** **Position Purpose:** Performs clinical reviews needed to resolve and process appeals...analyzing the basis for the appeal + Ensures timely review , processing, and response to appeal in accordance with… more
