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Manager, Secondary Review & Notificantion
JOB SUMMARY The Manager, Secondary Review & Notification is responsible for managing the Secondary Review & Notification, RN team. Responsible for managing escalations of redeterminations related to LTSS service approvals, denials, increases, reductions and terminations, as well as service planning and documentation to ensure appropriate services are rendered. JOB SPECIFICATIONS Responsible for oversight of the secondary review process for LTSS services including approvals, denials, increases, reductions and terminationsResponsible for oversight of the notification process for acute and LTSS services Monitor letter generation and mailing accuracy of all adverse
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