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Care Review Processor
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- Summary: Works within the Care Access and Monitoring (CAM) team to provide clerical and data entry support for
- Members that require hospitalization and/or utilization review for other healthcare services.
- Checks eligibility and verifies benefits, obtains and enters data into systems, processes requests, and triages members and information to the appropriate Health Care Services staff to ensure the delivery of high quality, cost-effective healthcare services according to State and Federal requirements to achieve optimal outcomes for
- Participates in interdepartmental integration and collaboration to enhance the continuity of care for
- members including Behavioral Health and Long Term Care. Contact physician offices according to Department guidelines to request missing information from authorization requests or for additional information as requested by the Medical Director.
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