In this role, you will ensure team compliance with departmental policies, regulatory requirements and professional standards; keeps policies and procedures up - to - date and participates in revisions as needed.
In this position, you will provide behavioral health care management services through prospective, concurrent and retrospective evaluation and review of treatment. Ddetermines medical necessity, level of care required and quality of care provided.
In this role, the selected candidate will be responsible to maintain a close working relationship with our provider services team to ensure compliance on issues related to supporting or supplying required documentation for court or legal proceedings as needed.
The nurse care manager helps to accurately and efficiently identify patients appropriate for care management and assists with the development and implementation of care management processes in a quality focused, cost - effective manner across the continuum of care.
In this role, you will be responsible to perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care.