BHPS provides Utilization Review services to its clients. The UM Denials Coordinator supports the Utilization Management function by reviewing denied and partially denied authorizations and preparing denial correspondence within the Utilization Management system. This role is res...

The Quality Nurse ensures the organization provides quality patient care by leveraging relationships across teams, patients, and providers, participating in clinical and quality management activities like audits and medical record reviews. Major duties include performing chart audits, interacting with patients for counseling, tracking quality results for continuous improvement, and collaborating with the Director on auditing processes and training.

HealthPartners is hiring a Clinical Review Pharmacist. Service excellence is to be centered on patient care and patient relationships and is the responsibility of all employees. Teamwork is the norm and all employees will be held accountable to work as effective team members. The...

The Medical Case Manager is responsible for reviewing and processing requests for authorization and notification of behavioral health services from various providers, utilizing established medical criteria and policies. This role involves direct interaction with providers, screening cases for Medical Director review, and completing necessary documentation in the utilization management system.