Impactful Utilization Management Clinician

PacificSource; Bend (OR); On-site; USD 70,000 - 90,000; Full time

Job summary

PacificSource seeks a qualified healthcare professional to join our Utilization Management team in Bend, Oregon. You will assess member information, coordinate resources, and support cost-effective care while ensuring quality outcomes.

Responsibilities include documenting case notes for records, performing concurrent reviews for inpatient and residential care, and maintaining collaboration with hospital staff to determine appropriate levels of care and discharge planning.

Responsibilities

• Collect and assess member information to promote wellness, appropriate utilization, and cost-effective care.
• Coordinate resources to achieve member outcome goals and objectives.
• Accurately document case notes and letters of explanation for legal records.
• Perform concurrent review of members admitted to inpatient facilities, residential treatment centers, and partial hospitalization programs.
• Maintain contact with inpatient facility utilization review personnel to assure appropriateness of continued stay and level of care.

Job description

PacificSource seeks a qualified healthcare professional to join our Utilization Management team in Bend, Oregon. You will assess member information, coordinate resources, and support cost-effective care while ensuring quality outcomes.

Responsibilities include documenting case notes for records, performing concurrent reviews for inpatient and residential care, and maintaining collaboration with hospital staff to determine appropriate levels of care and discharge planning.