PacificSource Health Plans
1001 - 5000 employees
Founded 1933
⚕️ Healthcare Insurance
💸 Finance
🧘 Wellness
Healthcare Insurance • Finance • Wellness
PacificSource Health Plans is a healthcare provider that offers a range of health insurance solutions, including plans for individuals, families, and employers. Their offerings include Medicare and Medicaid plans, dental coverage, and administrative services for small and large groups. Committed to member care, PacificSource emphasizes customer service and provides various resources for health management, including mental health support and wellness programs.
Utilization Management Clinician – Tuesday, Saturday
Job not on LinkedIn
🔥 2 hours ago
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PacificSource Health Plans
1001 - 5000 employees
Founded 1933
⚕️ Healthcare Insurance
💸 Finance
🧘 Wellness
Healthcare Insurance • Finance • Wellness
PacificSource Health Plans is a healthcare provider that offers a range of health insurance solutions, including plans for individuals, families, and employers. Their offerings include Medicare and Medicaid plans, dental coverage, and administrative services for small and large groups. Committed to member care, PacificSource emphasizes customer service and provides various resources for health management, including mental health support and wellness programs.
📋 Description
• Collaborate closely with physicians, nurses, social workers, and a wide range of medical and non-medical professionals • Assess the member’s specific health plan benefits and additional resources available • Provide utilization management (UM) services that promote quality, cost-effective outcomes • Facilitate outstanding member care using fiscally responsible strategies • Accurately document case notes and letters of explanation • Perform concurrent reviews of members admitted to inpatient facilities and maintain contact with utilization review personnel
🎯 Requirements
• Minimum of three (3) years of nursing or behavioral health experience • Active, unrestricted Registered Nurse (RN) license OR Licensed Professional Counselor (LPC) OR Licensed Marriage and Family Therapist (LMFT) OR Licensed Clinical Social Worker (LCSW) OR Psychiatric Mental Health Nurse Practitioner (PMHNP) • Case Manager Certification as accredited by CCMC preferred • Thorough knowledge of medical and behavioral health processes, diagnoses, care modalities, procedure codes including ICD and CPT Codes, health insurance, and state-mandated benefits • Ability to use computerized systems for data recording and retrieval
🏖️ Benefits
• Flexible telecommute policy • Medical, vision, and dental insurance • Incentive program • Paid time off and holidays • 401(k) plan • Volunteer opportunities • Tuition reimbursement and training • Life insurance • Options such as a flexible spending account
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