CommunityCare

Responsible for the clinical review of utilization requests and the implementation of care coordination for high-risk and institutionalized populations. Collaborates with providers to determine medical necessity and ensure appropriate service delivery across the healthcare continuum.

Responsible for the clinical review of utilization requests and the implementation of care coordination for high-risk and institutionalized members. Collaborates with providers to ensure medical necessity and appropriateness of services across the healthcare continuum.