Rn Behavioral Health Case Manager/Utilization Management
Seattle, Washington, United States
- Manages Uniformed Services Family Health Plan (USFHP) members during inpatient or outpatient stays for mental health, chemical dependency, and eating disorder issues- Collaborates with USFHP case management staff on decisions regarding ongoing care.- Provides ongoing review of outside care for all external USFHP referrals for psychiatry and/or therapy.- Makes recommendations to the Medical Director regarding continuing outside care for specialty services not available within network.- Advises patients and families regarding benefits, resources, and home management options.- Educates and directs providers both within and outside the Pacific Medical system regarding benefits and utilization of services.- Responsible for managing complex patients in the outpatient setting utilizing homecare, hospice, DME and other appropriate agencies- Recommends care plan for high risk patients in the outpatient setting including communication with physicians, nurses, homecare providers or others as applicable.- Acts as a resource for managed care plan; utilizes knowledge of managed care plan administrated by Pacific Medical Centers to coordinate patient care