More than healthcare, More than a job, More than a workplace. Want More?
Cenpatico is dedicated to Improving Lives and that starts with hiring top talent like YOU!
Cenpatico is a place where creativity and new ways of thinking and ideas thrive. We make a difference through our people. Our staff have innovative ideas, a passion for serving our members, and develop strong community partnerships.
We are looking for dynamic and talented individuals to join the organization who want to make a difference in the lives of others. We want to hear from you. Tell us how your passion and experiences can help us improve lives each day.
Cenpatico offers exciting and rewarding careers with excellent benefits and a very competitive compensation package.
We are also offering a Sign-On Bonus for this position.
Position Purpose: Supervise and facilitate the daily operations of the case management and utilization management functions.
- Oversee the workflow and day-to-day operations of high risk case management and utilization management functions, including implementatoin of policies and procedures.
- Ensure compliance with established initial and concurrent review, case management, referral, pre-certification and authorization policies, procedures and processes.
- Act as a liasion with other business units and facilitate on-going communications between case management and utilization management staff, communinity agencies and contracted providers.
- Provide oversight of telephonic review of inpatient admissions with doctors, hospitals, and other providers.
- Monitor the effectiveness for existing outreach efforts and ensure appropriate knowledge/education and interventions are conducted for members defined to be at risk.
- Analyze data to address trends or potential quality improvement opportunities including provider issues, service gaps and member needs.