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Job Summary:
- Conducts medical necessity reviews.
- Performs reviews using InterQual Criteria.
- Communicates with the provider team.
Compliance:
- Completes Medicare notices.
- Ensures compliance with regulations.
- Maintains competencies and participates in process improvements.
Collaboration:
- Communicates with the provider team.
- Works with the Case Management Authorization Specialist.
- Serves as a resource to the provider team.
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