This role requires a high degree of coordination with external and internal business partners, including, but not limited to the UnitedHealthcare clinical services inpatient, intake/prior authorizations, appeals and grievance, quality, case and disease management, behavioral health, and other clinical specialties, external HCBS providers and vendors and, or national programs. This role works under the direct supervision of the DC Manager of Utilization Management, and is responsible for performing pre-service clinical coverage review of Private Duty Nursing (PDN) and Personal Care services (PCS) and other HCBS benefits using applicable benefit plan documents, evidence-based medical policy and nationally recognized clinical guidelines and criteria.