Impactful Utilization Management Clinician

PacificSource; Springfield (OR); In loco; USD 71.000 - 106.000; Tempo pieno

Descrizione del lavoro

PacificSource seeks an Utilization Management Clinician in Springfield, OR, to collaborate with physicians, nurses, social workers, and other professionals to coordinate delivery of healthcare services. You will assess member benefits and resources, and provide UM services to promote quality and cost-effective outcomes.

The role requires clinical licensure (RN/LPC/LMFT/LCSW/PMHNP) and a minimum of three years in nursing or behavioral health, with CCMC preferred.

Competenze

• Active, unrestricted RN, LPC, LMFT, LCSW, or PMHNP credential required.
• Minimum of three (3) years of nursing or behavioral health experience.
• Case Manager Certification (CCMC) preferred.

Mansioni

• Collect and assess member information to promote wellness, appropriate utilization, and cost-effective care.
• Coordinate necessary resources to achieve member outcome goals and objectives.
• Accurately document case notes and letters of explanation for legal records.
• Perform concurrent review of members in 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.

Conoscenze

Adaptability

Collaboration

Communication

Problem solving

Teamwork

Organizational skills

Formazione

Active, unrestricted RN/LPC/LMFT/LCSW/PMHNP credential

Descrizione del lavoro

PacificSource seeks an Utilization Management Clinician in Springfield, OR, to collaborate with physicians, nurses, social workers, and other professionals to coordinate delivery of healthcare services. You will assess member benefits and resources, and provide UM services to promote quality and cost-effective outcomes.

The role requires clinical licensure (RN/LPC/LMFT/LCSW/PMHNP) and a minimum of three years in nursing or behavioral health, with CCMC preferred.