RN Clinical Care Manager
At APS Healthcare, we are passionate about changing behaviors of all constituents in the healthcare system to improve health, optimize clinical quality, and reduce associated costs. Our mission, quite simply, is to improve the health of those we serve.
APS has an exciting opportunity for a RN Clinical Care Manager in our Charleston, WV office. The Care Manager's primary responsibilities include integration of clinical information related to prior authorization requests within established time frames for Medicaid outpatient behavioral health services and case discussions with providers regarding clinical recommendations/service utilization. This position will assist team members with updating utilization criteria, the development of internal review protocols and establishing individual recommendations for provider technical assistance and training related to best practices. The Clinical Care Manager will provide customer service, consultation to providers and contractors, and will have knowledge of behavioral health conditions, best practices and ability to integrate information for medical necessity determination.
Please refer to the Job Description for the qualifications.