Opportunity Description
Are you a registered nurse with a background in utilization management? UPMC Health Plan is looking for you!
We are hiring a full-time Utilization Management Care Manager to support the Utilization Management Clinical Operations Department. This position will predominantly work from home, standard daylight hours, Monday through Friday.
The Utilization Management (UM) Care Manager is responsible for utilization review of health plan services and assessment of member's barriers to care. Interacts daily with facility clinicians, physicians, and UPMC Health Plan care managers and Medical Directors as part of the member treatment team. Provides guidance and assistance to providers and members to ensure that health care needs are met through the delivery of covered services in the most appropriate setting and cost - effective manner.
Responsibilities:
+ Obtain documentation to support requested level of care within the defined health plan regulatory timefr...
We are hiring a full-time Utilization Management Care Manager to support the Utilization Management Clinical Operations Department. This position will predominantly work from home, standard daylight hours, Monday through Friday.
The Utilization Management (UM) Care Manager is responsible for utilization review of health plan services and assessment of member's barriers to care. Interacts daily with facility clinicians, physicians, and UPMC Health Plan care managers and Medical Directors as part of the member treatment team. Provides guidance and assistance to providers and members to ensure that health care needs are met through the delivery of covered services in the most appropriate setting and cost - effective manner.
Responsibilities:
+ Obtain documentation to support requested level of care within the defined health plan regulatory timefr...