Jonathan Schmolke Email & Phone Number

Northern California

Lafayette, California, United States

San Francisco Bay Area

Greater Los Angeles Area

Assist the review management staff and the QAQC reviewers in monitoring the time frames of all reviews to ensure timely completion.Coordinate the assignment, completion and delivery of CID’s determination of expedited reviews in the absence of the Clinical Director.Provide administrative support services and supervision of non-clinical staff.Oversee the Utilization Management administrative department including: a. Management of all aspects of non-clinical staff personnel including hiring, training, supervision and performance evaluation b. Performance of QAQC on administrative utilization management procedures including time frame adherence, oversight of customer satisfaction and customer relations, and communication and consultation with the Medical Director and Clinical Director in regard to performance of daily tasks.Serve on the CID’s “Utilization Review Policies and Procedures Committee”.Provide or designate a staff member to provide a written response to a complainant within 30 days of the complaint.Ensure that the annual complaint and URA summary report is tracked and maintained.Schedule periodic assessments for each non-clinical administrative staff member.Satisfy all non-clinical telephonic inquiries that the exceed the knowledge level of the non-clinical administrative staff so long as it does not violate CID’s confidentiality policy.Address telephonic situations where the party communicates to CID the health or safety of a patient is under immediate threat (in the absence of the Clinical Director).Serve on CID’s “QAQC Committee”.Ensure that CID maintains a toll free phone and fax number as well as a US postal address for use in UR operations and that these items are printed on all written communications generated by CID.Ensure that non-clinical administrative staff responds to mail inquiries, voice mail messages, email messages or fax messages within 1 business day of receipt.

Oversee phone support and customer relations.

Day to day administrative responsibilities.