Diagnostic Imaging Clinical Associate

1 day ago


Woodland Hills, California, United States Elevance Health Full time
About Elevance Health

We are a Fortune 25 company committed to advancing healthcare and making it simpler for our members and communities. Our values drive everything we do, from innovation to patient satisfaction.


Job Description

This role involves working as a Healthcare Review Specialist, conducting thorough medical necessity reviews for diagnostic imaging procedures and out-of-network services. You will collaborate with healthcare providers and members to promote optimal use of diagnostic imaging services and stay up-to-date with the latest clinical guidelines, policies, and procedures.


Key Responsibilities
  1. Conduct initial medical necessity screening and determine if clinical information presented meets medical necessity criteria or requires additional review
  2. Conduct initial medical necessity review of exception preauthorization requests for services requested outside of the client health plan network
  3. Notify ordering physician or rendering service provider office of the preauthorization determination decision

Benefits
  • Competitive salary range: $35.35 - $44.18 per hour
  • Comprehensive benefits package, including medical, dental, vision, and life insurance
  • Paid Time Off (PTO) and holidays


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