Clinical Care Manager

Posted 17 days agoViewed

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💎 Seniority level: Manager, Five years of experience in a variety of health care settings.

📍 Location: Illinois

💸 Salary: 75000.0 USD per year

🔍 Industry: Healthcare

🗣️ Languages: English

⏳ Experience: Five years of experience in a variety of health care settings.

🪄 Skills: Data AnalysisCommunication SkillsAnalytical SkillsCollaborationMicrosoft ExcelProblem SolvingAttention to detailOrganizational skillsTime ManagementWritten communicationMultitaskingComputer skills

Requirements:

Registered Nurse with an active and unrestricted License in the state of Illinois required.
Five years of experience in a variety of healthcare settings.
Knowledge of utilization review, managed care, and community health.
Computer skills including MS Word, Excel, MS Access.
Strong organizational, writing, and speaking skills.
Excellent clinical judgment and a positive attitude.

Responsibilities:

Performing utilization review services in compliance with federal and state regulations.
Obtaining, analyzing, and documenting all supporting clinical information.
Completing timely reviews of healthcare services and documenting medical criteria.
Communicating pre-certifications and concurrent review determinations.
Interfacing with medical directors and providers, managing referrals for disease management.
Managing after-hours communications, maintaining confidentiality, and participating in quality management activities.

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