Magellan Health
UM Care Manager - RN-1 (Healthcare)
General Job Information
Title
UM Care Manager - RN-1Grade
24Job Family
Clinical Services GroupCountry
United States of AmericaFLSA Status
United States of America (Exempt)Recruiting Start Date
6/24/2019Date Requisition Created
6/24/2019Work Experience
Clinical, Utilization ManagementEducation
Associates: Nursing (Required)License and Certifications - Required
LPN - Licensed Practical Nurse - Care Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care MgmtLicense and Certifications - Preferred
Other Job Requirements
Responsibilities
3 years experience post degree in a clinical, psychiatric and/or substance abuse health care setting. Also requires minimum of 3 years of experience conducting utilization management according to medical necessity criteria.-Able to demonstrate the ability to quickly develop an alliance with providers via telephone.-On call coverage of Nurse Line as requested or required of position.-RN or clinical credentials in a behavioral health field. If not an RN, must hold Masters or Doctoral Degree. If LPN, must work under the direct clinical supervision of a Registered Nurse (RN) Case Manager, Registered Nurse Utilization Management Professional (UMP), or Registered Nurse Clinical Manager.-Ability to use computer systems.-Good organization, time management and verbal and written communication skills.-Knowledge of utilization management procedures, Medicaid benefits, community resources and providers.-Knowledge and experience in diverse patient care settings including inpatient care.-Ability to function independently and as a team member.-Knowledge of ICD and DSM IV coding or most current edition. -Ability to analyze specific utilization problems and creatively plan and implement solutions.Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.