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Job Description: 
Provide comprehensive healthcare management services to facilitate appropriate healthcare treatment, effectively manage healthcare costs and improve healthcare program/operational efficiency involving clinical issues.

Determines medical necessity/ appropriateness.

Facilitates optimal outcomes Identifies and follow through with continuous quality/ compliance opportunities.

May also include identification of aberrance's and initiation of corrective action.

Educates/ empowers customers to ensure compliance, satisfaction and promote patient advocacy.

Optimize total costs Implementation and evaluation of policy based on usage and program directives.

Educate/empower colleagues at all levels to enable decision making at most appropriate level.

Requirements: