We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves
Essential Duties and Responsibilities: - Review cases and summarize the facts of each case and assess issues involved in the case to certify or non-certify requested treatments. - Provide written clinical rationales for CA Workers Compensation
Essential Duties and Responsibilities: - Responsible for reviewing favorable, and partially favorable, determinations in accordance with applicable regulations. - Render medical necessity determinations for Medicare State East cases assigned. - Resolve all other technical issues within