Preferred One Administrative Services Jobs & Careers

2 jobs

Preferred One Administrative Services
PreferredOne RN Complex Case Manager - Mental Behavioral Health Position Description Purpose Provide telephonic assessment of members’ pre-identified medical and/or behavioral health, or chronic illness state and determine the health care and educational needs related to their chronic illness, with the goal of achieving optimal clinical and resource outcomes. Duties and Responsibilities · De...

Preferred One Administrative Services
PreferredOne RN Case Reviewer Position Description Purpose Provide efficient, effective risk management according to each specific benefit plan for PreferredOne products, using utilization review Duties and Responsibilities § Utilize the Preferred One medical criteria and those of other regulatory bodies, (i.e. NCQA, DOH), the exempt and focused review programs, and the patient’s benefit pla...