Develop and maintain the pre-logic and clinical criteria in support of the prior authorization determination process.
November 13, 2022
Performs and draft medical review of incoming charts to determine if additional medical information is needed.
March 07, 2023
Participates in clinical staffing of cases and assists in coverage for specialized FRBH programs .
April 26, 2023
Provides training to Clinical Practitioners and other FRBH Staff Members regarding criteria inherent in appropriate level of care determinations, both in circumstances of case-specific determinations and in more general educational venues.
May 07, 2023
Reviews patient records noting significant conditions and reactions, notifies supervisor and/or physician of patient's condition and reaction to drugs, treatments, and significant incidents.
May 19, 2023