Wellmark Blue Cross and Blue Shield

Customer Support

• Support clinical staff by gathering data to complete medical necessity review process
• Complete outbound inquiries via phone/fax to obtain discharge dates
• Create and send letters to providers and/or members
• Collaborate with other care management teams and stakeholders

Health Services Clinical Support Specialist, Remote Eligible After Training

Medical Director

• Use evidence-based decision making to perform inpatient case reviews.
• Synthesize clinical information to document a clear summary of medically necessary determinations.
• Make recommendations on efficiencies and innovations.
• Partner across the organization with other internal teams like Business Analytics and Claims.
• Participate in rotating on-call schedule for weekend and holiday reviews.

Health Services Clinical Support Specialist, Remote Eligible After Training

Medical Director – Inpatient Utilization Management