…guidelines. Participates in developing department goals and clinical programming. + Performs utilization review as assigned. + Helps with Process and Quality

…monitoring and evaluation of case management services through the appropriate utilization of resources. Application of appropriate medical necessity tools to

…TRICARE directives, coordinating with the local Medical Home Port (MHP) clinic, utilization and Referral Management policies, and obtains additional clinical data as

…resource referrals as necessary. + Manage assigned case load, assessing utilization of resources and services, identifying patients that require additional

…for clients who present with mental health and addictive disorders + Review diagnosis, evaluation and treatment plans in collaboration with clients and/or

…high-risk patients. . Work in collaboration with the Healthcare team to track and review data for research projects as well as resource utilization related to

…the position:** As a Clinical Resource Manager you will provide hospital case management/ utilization review and discharge planning to determine care needs beyond

…patient's level of wellness, reducing unnecessary readmissions and ensuring appropriate utilization of in-network healthcare resources. The CCC will collaborate with

…and multidisciplinary care team, including quality of care measures and review . . Collaboration with other departments caring for Neurology/stroke patients (incl.

…clinicians through clinical supervision, weekly clinical team meetings to review cases and interact with colleagues, professional development opportunities,