HealthPartners is hiring a Clinical Review Pharmacist. Service excellence is to be centered on patient care and patient relationships and is the responsibility of all employees. Teamwork is the norm and all employees will be held accountable to work as effective team members. The...

The Medical Case Manager is responsible for reviewing and processing requests for authorization and notification of behavioral health services from various providers, utilizing established medical criteria and policies. This role involves direct interaction with providers, screening cases for Medical Director review, and completing necessary documentation in the utilization management system.

The nurse will deliver prompt and insightful triage via phone or messaging, applying critical thinking and clinical assessment skills to guide patients' healthcare decisions. Responsibilities also include proactive communication with the care team, providing stigma-free care, and maintaining complete medical documentation.

The Prior Authorization Clinician reviews proposed hospitalization, home care, and inpatient/outpatient services for medical necessity and efficiency to ensure members receive appropriate and timely care. Key functions include determining medical appropriateness using guidelines, performing utilization reviews, and communicating outcomes to providers and members.