Other Job Requirements
3-5 years experience in Social Work, Nursing, or Healthcare-related field, or relevant experience in lieu of degree., Experience in utilization management, quality assurance, home or facility care, community health, long term care or occupational health required.
Experience in analyzing trends based on decision support systems.
Business management skills to include, but not limited to, cost/benefit analysis, negotiation, and cost containment.
Knowledge of referral coordination to community and private/public resources.
Requires detailed knowledge of cost-effective coordination of care in terms of what and how work is to be done as well as why it is done, this level include interpretation of data.
Ability to make decisions that require significant analysis and investigation with solutions requiring significant original thinking.
Ability to determine appropriate courses of action in more complex situations that may not be addressed by existing policies or protocols.
Decisions include such matters as changing in staffing levels, order in which work is done, and application of established procedures.
Ability to maintain complete and accurate enrollee records.
Effective verbal and written communication skills. Ability to work well with clinicians, hospital officials and service agency contacts.
General Job Information
Work Experience – Required
Work Experience – Preferred
Education – Required
GED, High School
Education – Preferred
License and Certifications – Required
DL – Driver License, Valid In State – Other
License and Certifications – Preferred
CCM – Certified Case Manager – Care Mgmt, LCSW – Licensed Clinical Social Worker – Care Mgmt, RN – Registered Nurse, State and/or Compact State Licensure – Care Mgmt
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.