…+ Two years utilization and/or case management experience inhealthcare regulatory and managed care environments + American Case Management Certification (ACM) or

…with complex psychiatric/substance abuse cases preferred. + Experience in utilization management, managed care or a combination of experience which would provide

…responsible for receiving, reviewing, and processing all incoming Member referrals from the Medi-Cal managed health care plan. The Lead Care Manager will

…healthcare credentialing and compliance. The role involves ensuring providers meet managed care requirements and adhere to California-specific regulations.

…on referral cases to assist in determination of clinical appropriateness for level of care and Medicare/Medicaid and Managed Care related issues 3. Reviews

…to those candidates with previous experience working with the Medicaid population within a Managed Care Organization (MCO). Mileage is reimbursed as part of our

…Rate: $20.00 Position Summary: Full-time Community Resource Navigator position available for our Managed Care Department in Vancouver, WA. The role of the

…adapt and the courage to innovate. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid

…Experience in Behavioral Health is a bonus. The clinical trainer will teach managed care and clinical concepts, systems navigation, and documentation processes.

…and dedicated Referral and Scheduling Coordinator, to prepare and process all managed care referral paperwork, schedules and pre-registers patients for exams