Pennsylvania Licensed Care Manager

Job Summary

A company is looking for a UM Care Manager (RN) to support their UM Clinical Operations team.

Key Responsibilities

• Conduct utilization reviews and assess member barriers to care, ensuring coordinated discharges from inpatient settings
• Document clinical information and activities in the care management tracking system, identifying trends for improvement
• Collaborate with interdisciplinary teams to develop appropriate discharge plans and maintain communication with healthcare providers

Qualifications

• Minimum of 2 years of experience in clinical and/or case management nursing
• Minimum of 1 year of experience in Utilization Management
• Preferred experience in discharge planning for at least 1 year
• BSN preferred
• Registered Nurse (RN) licensure required