Healthcare Program Manager

4 giorni fa


Florence, Toscana, Italia US Tech Solutions A tempo pieno
Job Description

We are seeking a skilled Clinical Care Coordinator to join our team at US Tech Solutions. As a key member of our healthcare services group, you will play a vital role in reviewing and evaluating medical eligibility for benefits and clinical criteria.

Your primary responsibilities will include:

  1. Active Case Management: Assess service needs, develop action plans, and coordinate with members to ensure effective care coordination.
  2. Medical Review and Authorization: Evaluate coverage for requested services within benefit and medical necessity guidelines.
  3. Patient Education: Participate in direct intervention and patient education with members and providers regarding healthcare delivery systems.
  4. Knowledge Sharing: Maintain current knowledge of contracts and network status of all service providers.

You will work closely with our team to promote quality, cost-effective outcomes and provide exceptional customer service.



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