Utilization Management Clinician – Tuesday - Saturday
Posted 5ds ago
Employment Information
Report this job
Job expired or something wrong with this job?
Job Description
Utilization Management Clinician at PacificSource assessing member's health plan benefits and coordinating services. Working with healthcare professionals to promote quality, cost-effective healthcare outcomes.
Responsibilities:
- Collaborate closely with physicians, nurses, social workers, and a wide range of medical and non-medical professionals to coordinate delivery of healthcare services
- Assess the member’s specific health plan benefits and additional resources available
- Provide utilization management (UM) services which promote quality, cost-effective outcomes
- Facilitate outstanding member care using fiscally responsible strategies
- Collect and assess member information pertinent to member’s history in order to promote wellness
- Coordinate necessary resources to achieve member outcome goals and objectives
- Accurately document case notes and letters of explanation
Requirements:
- Minimum of three (3) years of nursing or behavioral health experience
- Experience in acute care, case management, including rehabilitation, home health, behavioral health and hospice treatment strongly preferred
- Active, unrestricted Registered Nurse (RN) license, LPC, LMFT, LCSW, or PMHNP credential required
- Case Manager Certification as accredited by CCMC preferred
- Thorough knowledge and understanding of medical and behavioral health processes, diagnoses, care modalities, procedure codes including ICD and CPT Codes, health insurance and state-mandated benefits
- Must be able to function as part of a collaborative, cohesive community
Benefits:
- Flexible telecommute policy
- Medical, vision, and dental insurance
- Incentive program
- Paid time off and holidays
- 401(k) plan
- Volunteer opportunities
- Tuition reimbursement and training
- Life insurance
- Options such as a flexible spending account
Similar Jobs
5d
Utilization Management Clinician – Tuesday, Saturday
Utilization Management Clinician coordinating healthcare delivery for PacificSource members through collaboration with medical professionals. Assessing health plan benefits and promoting quality outcomes.
5d
8d
Clinician
Population Health Program Clinician providing complex care coordination for individuals with chronic needs at Trillium Health Resources. Collaborating with care management teams to achieve optimal patient outcomes and promote health.
8d
No more related jobs available.