What are the responsibilities and job description for the Care Manager, Licensed, IN - Remote position at McLaren Integrated HMO Group?
Position Summary
Responsible for the review and authorization of all services to the members, utilizing expert knowledge of screening criteria, clinical criteria and research ability if no criteria exists. Uses independent judgment, when necessary, within scope of practice. Participates in the medical management of members in all product lines.Works with the PCP, the member, the Case Manager or Manager, Med Management and management to promote the delivery of quality services at the most appropriate and cost-effective setting. Performs as the member advocate with emphasis on education regarding managed care, disease management, care management, case management and PCP treatment plans. Monitors member’s utilization patterns for identification of high risk, and under and overuse of services. Collaborates with Case Manager or Manager, Med Management, Medical Director and senior management on complex cases.
This position is fully remote.
Equal Opportunity Employer of Minorities / Females / Disabled / Veterans
LI-AK1
Qualifications : Required :
- A valid current unrestrictive license in the state doing business in, in one of the following : LPN, LCSW, LMHC, LMSW, LMFT, LPC.
- Two (2) years clinical experience.
- One (1) year experience in Utilization Management, Medical Management, Case Management.
Preferred :
