Christine Ives

Responsible for independently reviewing outpatient medical reviews.

Utilizes nursing judgment and reasoning to analyze members clinical information.

Interacts with healthcare providers to make assessments based on clinical presentation and apply clinical guideline guidelines and or policies to evaluate medical necessity.

Communicates and collaborate with team leads and medical directors on complex cases when appropriate.

Responsible for independently performing care management within a scope of licenser for members with complex and chronic care needs by assessing developing implementing coordinating monitoring and evaluating care plans designed to optimize member healthcare across the Care continuum.