POSITION SUMMARY Provide medical oversight in appropriateness and medical necessity of healthcare services provided to Plan members, targeting improvements in efficiency and satisfaction for patients and providers, as well as meeting or exceeding productivity standards.
POSITION SUMMARY Responsible for coordination of daily UM functions in accordance with Molina Healthcare of WA policies and procedures. Coordinates decisions for all services requiring a medical necessity review including: inpatient and outpatient hospital services, diagnostic testing, equipment, home health care, and high cost injectable drugs.
POSITION SUMMARY Responsible for coordination of daily UM functions in accordance with Molina Healthcare of WA policies and procedures. Coordinates decisions for all services requiring a medical necessity review including: inpatient and outpatient hospital services, diagnostic testing, equipment, home health care, and high cost injectable drugs.
POSITION SUMMARY Responsible for supporting service coordination activities and functions for the STAR & CHIP population in accordance with Molina policies, procedures, and processes. Interacts with Molina Nurses, Medical Director and providers to ensure the delivery of high quality, cost effective healthcare for Molina members.
POSITION SUMMARY Responsible for the assessment and review, coordination and distribution of review decisions for members identified with medical, surgical, and long-term care, needs including home and community-based waiver recipients. Interacts with Medical Directors, HCS department staff, various other Molina staff and providers and practitioners to ensure timely receipt of decisions in accordance with Molina policies, procedures and processes.
POSITION SUMMARY : Responsible for supporting service coordination activities and functions for the STAR & CHIP population in accordance with Molina policies, procedures, and processes. Interacts with Molina Nurses, Medical Director and providers to ensure the delivery of high quality, cost effective healthcare for Molina members.
POSITION SUMMARY Responsible for the assessment, planning, implementation, coordination, monitoring, and evaluation of case management services for members identified with complex medical, surgical, mental health and/or chemical dependency requiring social service support services.
POSITION SUMMARY Responsible for the assessment, planning implementation, coordination, monitoring, and evaluation of case management services for members identified with complex medical, surgical, mental health and/or chemical dependency and social service support issues.
POSITION SUMMARY Responsible for supporting service coordination activities and functions for the Medicaid population in accordance with Molina policies, procedures, and processes. Interacts with Molina Nurses, Medical Director and providers to ensure the delivery of high quality, cost effective healthcare for Molina members.
POSITION SUMMARY Responsible for supporting service coordination activities and functions for the Medicaid population in accordance with Molina policies, procedures, and processes. Interacts with Molina Nurses, Medical Director and providers to ensure the delivery of high quality, cost effective healthcare for Molina members.
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