Licensed Utilization Management Case Manager

A company is looking for a UM Case Manager.

Key Responsibilities

Provide case management services including pre-certification, assessment, and coordination of care for assigned members

Document all determinations and interventions in accordance with established standards and guidelines

Monitor assigned caseload to meet performance metric requirements and function as a clinical resource for the care team

Required Qualifications

Licensed as RN, LPN, LMSW, LMHC, LMFT, LCSW, PT, OT, and / or ST

For CASAC positions : Credentialed Alcohol and Substance Abuse Counselor

Master's degree in a related discipline is preferred

Experience in managed care and case management

Knowledge of Interqual and / or Milliman criteria and relevant regulations