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Clinical review of medical management cases for hospital admissions, pre hospital admissions, therapies and Rehabilitation . Coordinated member care with Medical Directors and Case management to ensure smooth transition of care for members .
Was main preceptor for new UM staff and was part of the team assigned to onboard a new site in Atlanta where I was the UM preceptor for 10 new staff .
Working with a peer provided educational updates to staff on new processes using both meetings and power point presentations.
I had multiple roles at this company including :
Utilization Management
Case Management
Appeals Coordinator
Selected to be part of a Radiology Review pilot program