Managed Care SpecialistDepartment Description The Managed Care Utilization Management department includes the combined responsibilities of Utilization Management, Member Services, and care coordination, as well as data analytics for auditing compliance with regulatory and contractual metrics for HMO and ACO populations. The Utilization Management (UM) unit of the department insures services/care rendered to UCDMG capitated members are medically necessarily/appropriate and in conformance clinically with the benefits of the member's Health Plan. Job Summary
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