Kaiser Permanente
Portland, OR
Job Summary: Under direct and indirect supervision manages, analyzes, processes and authorizes referred out home health and home infusion referrals for Portland metro area and Salem/ Longview. Essential Responsibilities: Under direct and indirect supervision, analyzes referral requests for home health and home infusion to assure they meet established program criteria. Interprets referral limitations, Benefits and communicates this information to members, non-plan providers, NWP providers and other internal staff as appropriate. Receives information from contracted and non-contracted vendors related to the admission of KP members. Processes referrals for contracted vendors in Portland, Salem and Longview according to Provider Contracting agreements and Health Plan Service Agreements. Communicates benefit information to home health and home infusion providers. Accurately provides authorization for home health and home infusion in Tapestry as directed by the Home Health...