LPN UM Reviewer
The LPN UM Reviewer evaluates prior authorization requests by applying clinical guidelines and medical necessity criteria. They also coordinate care with providers and ensure compliance with health plan and regulatory requirements.
The LPN UM Reviewer evaluates prior authorization requests by applying clinical guidelines and medical necessity criteria. They also coordinate care with providers and ensure compliance with health plan and regulatory requirements.
The supervisor oversees daily telecommunications operations, coordinates team priorities, and serves as the primary liaison for the contact center. They are also responsible for training staff, managing system upgrades, and participating in an on-call rotation for urgent technical issues.
Handle inbound patient calls to schedule appointments, coordinate refill requests, and perform outbound outreach. Document patient interactions and route messages accurately within the Electronic Medical Record system.