π July 14
π² North Carolina β Remote
π΅ $91.6k - $160.3k / year
β° Full Time
π Senior
π΄ Lead
π Manager
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β’ Oversee daily UM operations for inpatient services including clinical review, authorization, and concurrent review processes β’ Ensure timely level of care determinations alignment with clinical guidelines and regulatory requirements β’ Collaborate with hospital case managers, providers, and interdisciplinary teams to facilitate safe and cost-effective discharge plans for patients β’ Monitor and track and analyze inpatient length of stay metrics, readmissions, key performance indicators (KPIs), and turnaround times β’ Establish effective transitions of care with post-acute providers
β’ Minimum of seven (7) years of clinical experience required β’ Minimum of 3 years direct health plan experience in case management, utilization management, or disease management β’ Registered Nurse or Licensed Clinical Social Worker with current appropriate state licenses β’ Certified Case Manager Certification as accredited by CCMC preferred β’ Thorough knowledge and understanding of medical procedures, diagnoses, care modalities, procedure codes, including ICD-9 & 10, CPT codes, health insurance and State of Oregon mandated benefits
β’ Health insurance β’ 401(k) matching β’ Paid time off β’ Professional development opportunities
Apply Nowπ July 14
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β° Full Time
π‘ Mid-level
π Senior
π Manager
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β° Full Time
π‘ Mid-level
π Senior
π Manager
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β° Full Time
π Senior
π Manager
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β° Full Time
π‘ Mid-level
π Senior
π Manager
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