Medical Management focuses on ensuring members receive safe, high‑quality, and medically appropriate care. The department oversees utilization management, case management, and care coordination activities, working closely with clinicians, providers, and internal teams. Medical Management reviews services for medical necessity, supports members with complex or chronic conditions, and helps guide members to the right care at the right time. Their work plays a key role in improving health outcomes, supporting compliance with clinical guidelines, and managing overall healthcare costs.
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Career Level
Intern
Education Level
No Education Listed