…TRAVEL/FULLY REMOTE.** **Position Purpose:** Develops, assesses, and facilitates complex care management activities for primarily physical needs members to provide

…PICU, NICU, or home health settings. Additionally, case management experience in a managed care or clinical setting is essential.** **This position will require

…Required - 5 years of experience in discharge planning, social services, home health, managed care , care management, case management or utilization review.

…or exceeds standards set by the facility. + Educate patients on both clinical and managed care . + Participate in clinic and network task forces as requested and

…Experience with office medical procedures and treatments and knowledge of insurance, managed care operations, EMR and scheduling software preferred. Additional

…model + Discharge Planning Experience + Motivational Interviewing skills + Managed Care /Utilization Review Experience + Clinical experience and demonstrated

…information utilizing internal or electronic sources. + Obtains and documents managed care referrals, required pre-certifications and authorizations as necessary

…Experience with office medical procedures and treatments and knowledge of insurance, managed care operations, EMR and scheduling software preferred. Additional

…Accreditation, certification in Utilization Management (CPUM), Health Care Management (CPHM), Managed Care Nurse (CMCN) or Case Management (CCM)

…experience and requires a minimum of 2 years clinical, utilization review, or managed care experience; or any combination of education and experience, which