RN Clinical Review Prior Authorization UM Specialist - Bloomington, MN, United States
3 days ago

Job summary
HealthPartners is hiring a RN Clinical Review Prior Authorization UM Specialist.Responsibilities
- Maintain an understanding of state and federal regulations, accreditation standards, HealthPartners products and networks, member contracts and Health Plan policies and procedures related to Utilization Management ,
- Investigate and respond to complex, high profile, and/or escalated customer questions, issues, and requests. ,
- Responsible for accurately interpreting coverage criteria and making correct determinationsand communicating relevant information to providers and members. ,
Job description
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