State Licensed Case Manager

Job Summary

A company is looking for a UM Case Manager - 100% Remote.

Key Responsibilities:

• Coordinate care plans for assigned members, including pre-certification, concurrent review, and discharge planning
• Assess medical, psychological, and social issues, and collaborate with healthcare providers for treatment coordination
• Document all interventions and determinations according to regulatory guidelines and performance metrics

Required Qualifications:

• Active RN, LPN, LMSW, LMHC, LMFT, LCSW, PT, OT, and/or ST license
• Master's degree in a related discipline (preferred)
• Experience in managed care and case management
• Knowledge of Interqual and/or Milliman criteria
• Relevant clinical work experience