Job Summary
A company is looking for a Care Coordinator, FEP Behavioral Health, who will perform medical necessity reviews and ensure compliance with criteria and policies.
Key Responsibilities:
- Perform medical necessity reviews for inpatient, prospective, and retrospective cases
- Consult with Medical Directors when care does not meet criteria or policies
- Document clinical information accurately and in a timely manner
Required Qualifications:
- Bachelor's degree or four years of work experience
- Current State Licensure as a registered nurse
- 3 years of clinical experience
- Utilization Management experience
- Experience working in a health plan industry
