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Licensed Utilization Management Case Manager
Job Summary
A company is looking for a UM Case Manager.
Key Responsibilities:
- Coordinate care plans, including pre-certification, concurrent review, and discharge planning for assigned members
- Document all determinations and interventions in accordance with established standards and guidelines
- Function as a clinical resource for the care team to enhance member care quality and manage medical costs
Required Qualifications:
- RN, LPN, LMSW, LMHC, LMFT, LCSW, PT, OT, and/or ST license
- For CASAC positions: Credentialed Alcohol and Substance Abuse Counselor
- Master's degree in a related discipline (preferred)
- Experience in managed care and case management
- Knowledge of CMS or NYSDOH regulations (preferred)
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COMPLETE JOB DESCRIPTION
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