Oversees UR, compliance, and cross-departmental coordination across all health plan lines of business, including Medicaid (STAR, STAR+PLUS), CHIP (CHIP, CHIP Perinate), Medicare and Duals (D-SNP, Medicare Advantage, Medicare Dual Aligned), and Commercial and Specialty lines (Preferred Administrators, HCO). Coordinates closely with Case Management to support seamless care transitions and with the Pharmacy Department to streamline medication-related authorizations, helping ensure each member receives appropriate, high-quality care in a timely manner.