The role involves reviewing clinical documentation to determine medical necessity and performing functional needs assessments to support service coordination. You will also manage referrals, document clinical determinations, and provide subject matter expertise to stakeholders while supporting quality activities.
The Clinical Reviewer evaluates clinical documentation to determine the medical necessity and appropriateness of behavioral health services. They also perform functional needs assessments and coordinate care for individuals across in-home and community-based settings.
The Associate Improvement Advisor will support operational, administrative, and regulatory activities for the HSI Utah HUB contract. Responsibilities include managing communications, maintaining operational records, and coordinating meeting logistics.
The Improvement Advisor supports the planning and operational coordination of the Utah Community Care Hub by collaborating with health care providers and community organizations. They provide technical assistance, facilitate learning collaboratives, and guide partners through quality improvement and care coordination initiatives.
The Improvement Advisor will guide organizations through quality improvement and population health initiatives while coordinating the Utah Community Care Hub. They will also facilitate learning collaboratives, design evidence-based interventions, and support clinical-community referral workflows.
The Clinical Reviewer conducts prospective, concurrent, and retrospective utilization management reviews to assess medical necessity and quality of care. They also collaborate with internal teams and provide subject matter expertise while maintaining accurate documentation and regulatory compliance.
The Research Associate II manages and implements research studies and evaluation projects while contributing to data analysis and reporting. They also conduct data collection activities such as surveys, interviews, and focus groups while maintaining project timelines and deliverables.
The Clinical Reviewer evaluates clinical documentation to determine the medical necessity and appropriateness of behavioral health services. They also perform functional needs assessments and coordinate care for children, youth, and adults within the assigned region.
The Clinical Reviewer evaluates clinical documentation to determine the medical necessity and appropriateness of behavioral health services. They also conduct functional needs assessments and coordinate care for individuals across community-based settings.
The Clinical Reviewer evaluates clinical documentation to determine the medical necessity and appropriateness of behavioral health services. They also perform functional needs assessments and support care coordination to connect individuals with community-based services.
The analyst will lead departmental budgeting, financial planning, and the development of pricing strategies for new and existing business. They will also build complex financial models to project revenue and expenses while providing actionable insights to leadership.
Clinical Reviewers evaluate therapy authorization requests and medical records to determine the medical necessity and appropriateness of care. They document decisions, apply clinical guidelines, and collaborate with providers and physician advisors to ensure accurate and timely review outcomes.
The Senior Improvement Advisor provides expert consultation and project leadership to healthcare organizations serving American Indian and Alaska Native communities. They are responsible for designing learning collaboratives, facilitating technical assistance, and building strong relationships with Tribal leaders and healthcare partners.
The Clinical Reviewer evaluates clinical documentation to determine the medical necessity and appropriateness of behavioral health services. They also perform functional needs assessments and coordinate care for children, youth, and adults within an electronic medical record system.
The Clinical Reviewer evaluates clinical documentation to determine the medical necessity and appropriateness of behavioral health services. They also perform functional needs assessments and support service coordination to connect individuals with community-based care.
