Senior Case Manager: Utilization & Care Coordination

Healthfirst

New York (NY)

Hybrid

USD 73,000 - 120,000

Full time

4 days ago

Be an early applicant

Application generator

A complete application in a minute — tailored resume and cover letter, ready to send.

Get past ATS filters

Benefits offered by this job

Medical, dental & vision coverage

401k contributions

Job summary

Healthfirst is seeking a Case Manager, Utilization Management to coordinate care plans for members, perform pre-certification and concurrent reviews, and ensure efficient utilization of health services. This role supports quality outcomes and participates in performance metrics within a large New York-based health plan.

The position requires relevant clinical licenses (RN/LPN/LMSW/LMHC/LMFT/LCSW) and experience in mental/behavioral health settings, with opportunities in a comprehensive benefits

Qualifications

RN, LPN, LMSW, LMHC, LMFT, LCSW, PT, OT and/or ST licenses are required.
3 years of mental/behavioral health or addictions setting experience preferred.
CASAC credential for CASAC positions.

Responsibilities

Provide case management for assigned caseloads including pre-certification, concurrent reviews, and discharge planning.
Identify medical, psychological, and social issues needing intervention and coordinate treatments.
Document determinations and communications per standards and regulations.

Skills

Case management

Clinical coordination

Documentation

Advocacy

Interdisciplinary collaboration

Education

RN license

LPN license

LMSW

LMHC

LMFT

LCSW

PT license

OT license

CASAC credential

Tools

InterQual/Milliman knowledge

CMS/NYSDOH regulations knowledge

Excel

PowerPoint

Job description

The position requires relevant clinical licenses (RN/LPN/LMSW/LMHC/LMFT/LCSW) and experience in mental/behavioral health settings, with opportunities in a comprehensive benefits

Get your free, confidential resume review.

or drag and drop your file here.