NeueHealth

The UM Coordinator manages the administrative functions of the utilization review process, including processing authorization requests and coordinating with providers. They ensure medical necessity reviews are completed timely and in compliance with regulatory guidelines.

The PA Nurse evaluates prior authorization requests for treatments and procedures to ensure alignment with medical necessity criteria and coverage policies. They act as a liaison between providers, patients, and health plans while documenting all activities in EMR systems.

The Concurrent Utilization Review Nurse conducts real-time clinical reviews to ensure the medical necessity and appropriateness of healthcare services. They also coordinate with healthcare providers and the Medical Director to facilitate care transitions and manage authorization requests.

The Associate, Affiliate Growth will support business development and growth initiatives focused on recruiting physicians into NeueHealth’s portfolio of value-based contracts across Medicare ACOs, ACA, Medicaid, and Medicare Advantage. This involves owning the entire business development process, from pipeline generation through to closing deals with independent primary care practices.

This role supports business development and growth initiatives focused on recruiting physicians into value-based contracts across Medicare ACOs, Medicaid, Medicare Advantage, and ACA markets. Responsibilities include owning the entire business development process from pipeline generation to closing deals and supporting affiliate performance tracking.

The Associate, Affiliate Growth will support business development to recruit physicians into value-based contracts across Medicare ACOs, Medicaid, Medicare Advantage, and ACA markets. This involves owning the entire business development process, from pipeline generation through closing deals, while building relationships with independent primary care practices.