Post Date 09/02/2009 Employer WellPoint, Inc Benefits Job Description American Imaging Management (AIM) is the nations leading provider of diagnostic imaging management services. Our clinical operations group seeks a experienced nurses to join our collegial team of Nurse Reviewers in AIMs newly-opened Glendale, CA contact center. Nurse reviewers are responsible for conducting preauthorization, out of network and appropriateness of treatment reviews for diagnostic imaging services by utilizing appropriate policies, clinical and department guidelines. They collaborate with healthcare providers, and members to promote the most appropriate, highest quality and effective use of diagnostic imaging to ensure quality member outcomes, and to optimize member benefits. * Receive preauthorization requests from front-line Referral Specialists through direct call transfer * Conduct initial medical necessity clinical screening * Determine if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review * Conduct initial medical necessity review of exception preauthorization requests for services requested outside of the client health plan...

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