Concurrent Review Care Coordinator - EviCore - Work at Home

The UM Clinical Reviewer Senior Analyst is responsible for concurrent review, care coordination, and utilization management activities across post-acute care settings. The role applies clinical judgment, evidence-based guidelines, and organizational policies to support quality outcomes, cost-effective care, and member experience. Key Responsibilities Implement, evaluate, and coordinate individualized plans of care for assigned members. Conduct utilization and concurrent reviews in alignment with medical necessity criteria and regulatory requirements. Collaborate with providers, Medical Directors, and interdisciplinary teams to support transitions of care. Identify gaps or deviations in care plans and intervene appropriately to support desired outcomes.…