Ltss Coordinator Jobs in Oregon

Participates in Quality Reviews and Inter Rater Reliability processes and achieves performance results at or above thresholds established by management.

Submits appropriate documentation/clinical information in enterprise platform systems record keeping and documentation requirements.

Maintains awareness and complies with Plan CHC authorization timeliness standards based on DHS/NCQA requirements.

Documents date that the request was received, nature of request, utilization determination (and events leading up to the determination).

Verifies and documents Participant eligibility for services.

Accessing and applying Medical Guidelines for decision making prior to Medical Director/Physician Advisor referral.