…Accredited Case Manager (ACM-RN), or UM Certification preferred + Knowledge of managed care and payer environment preferred. **Overview** St. John's Regional

…to obtain. * Experience utilizing motivational interviewing preferred. * Experience working with managed care in a health care setting preferred. *

…setting, preferably hospital or clinic** + **Knowledge of Medicare, Medicaid, and managed care reimbursement methodologies** + **Ability to review clinical

…Working in an organization of size and complexity comparable to Corewell Health or managed care organization Preferred + 5 years of relevant experience Related

…physical health and/or substance abuse benefits, community treatment resources, mental health managed care programs, and company policies and procedures. +

…MCG, InterQual, and others as needed). + Requires a solid understanding of managed care methodologies, HCFA/OBRA and state of Connecticut regulatory compliance

…knowledge base of health care delivery and case management within a managed care environment. + Comprehensive knowledge of Utilization Review, levels of

…the Commission for Case Manager Certification (CCMC) or the American Association of Managed Care Nurses (CMCN) desired. We're ChenMed and we're transforming

…Basic Life Support Certified/certification eligible in relevant specialty such as: + Certified Managed Care Nurse through the American Board of Managed

…information utilizing internal and electronic sources. 23. Obtains and documents managed care referrals, required pre-certifications and authorizations as