Utilization Management

• Identifying, monitoring, evaluating, and resolving issues that may cause inefficient or inappropriate care delivery of care at the MTF
• Acting as a conduit for sharing information between PCM, patient, and patient admission team to prevent patient harm
• Be a liaison for TRICARE Overseas and MTF TRICARE representatives
• Assisting in tracking, verifying, and creating referrals to prevent delay in care
• Monitoring the Nurse Advise Line to ensure patients are getting proper care within the MTF or host nation hospital
• Tracking referrals CONUS/OCONUS via ISOS
• Working with AE case manager and HN case manager to ensure patient receives pertinent information to future clinic referrals
• Advocating on patient's behalf when needed