Behavioral Health Care Manager Resume Samples

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AB
A Bosco
Anais
Bosco
723 Malachi Squares
San Francisco
CA
+1 (555) 325 5359
723 Malachi Squares
San Francisco
CA
Phone
p +1 (555) 325 5359
Experience Experience
Philadelphia, PA
Behavioral Health Care Manager
Philadelphia, PA
Gerhold, Skiles and Carroll
Philadelphia, PA
Behavioral Health Care Manager
  • Collaborates with the PCP and follows through with the identified plan in a timely manner
  • Communicates with the PCP and team at specific identified times the status of patients at high risk
  • Provides consultation to CM colleagues for patients with BH issues
  • Competency in this position is dependent upon the patient population as the position does provide patient care/services
  • Knowledge of disease processes and/or diagnosis
  • Familiarity with guardianship issues
  • Embraces technological advances that allow SHCN to communicate information effectively and efficiently
New York, NY
Behavioral Health Care Manager / Consultant
New York, NY
Muller LLC
New York, NY
Behavioral Health Care Manager / Consultant
  • Facilitates implementation of the behavioral health collaborative care model in primary care or subspecialty medical/surgical practice setting
  • Collaborates with clinical and non-clinical practice staff on the performance of behavioral health screening and related processes
  • Performs psychosocial care management in primary care or subspecialty medical/surgical practice setting
  • Serves as a liaison with behavioral health service line to facilitate practice adoption of new technologies, including telepsychiatry capabilities
  • Coordinates necessary resources to move patient along continuum in a timely manner
  • Serves as a resource to physician and staff by providing guidance and solutions in behavioral health-related processes (screening, treatment algorithms, psychopharmacology principles, escalation, psychiatric consults, etc.)
  • Monitors, documents, and follows up on practice behavioral health activities to ensure integration and compliance. Prepares and presents reports to service line leadership
present
Houston, TX
Behavioral Health Care Manager Tx-irving After Hours Lcsw
Houston, TX
Lang and Sons
present
Houston, TX
Behavioral Health Care Manager Tx-irving After Hours Lcsw
present
  • Performs other duties as assigned
  • Clearly and completely documents all initial and concurrent reviews, including, but not limited to diagnosis, symptoms, interventions, goals and plan for next review
  • Closes all cases according to the defined case closure procedure in a timely manner, and in accordance with guidelines established by the department Director
  • Participates in training of other Care Managers as necessary
  • Completes EAP authorizations as assigned
  • Attends weekly Administrative and Peer Review Committee meetings
  • Authorizes inpatient and/or outpatient treatment according to company's stated criteria
Education Education
Master’s Degree in Behavioral Health
Master’s Degree in Behavioral Health
The University of Texas at Austin
Master’s Degree in Behavioral Health
Skills Skills
  • Intermediate ability to work independently Ability to work independently, handle multiple assignments and prioritize workload
  • Intermediate ability to multi-task
  • Intermediate demonstrated time management and priority setting skills
  • Intermediate demonstrated interpersonal/verbal communication skills; communicates effectively in person and by phone
  • Advanced ability to create, review and interpret treatment plans Ability to create, review and interpret treatment plans
  • Intermediate ability to effectively present information and respond to questions from families, members, and providers
  • Intermediate knowledge of healthcare delivery
  • Intermediate knowledge of community, state and federal laws and resources
  • Intermediate demonstrated written communication skills
  • Intermediate demonstrated customer service skills
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13 Behavioral Health Care Manager resume templates

1

Behavioral Health Care Manager Resume Examples & Samples

  • Conducts comprehensive assessments of referred member's needs and benefit plan eligibility, and develops a care management treatment plan for members with high level acuity needs
  • Interacts continuously with members, family, physician(s), and other resources to determine appropriate behavioral action needed to address/support medical needs. Reviews benefits options, researches community resources, coordinates services, trains/creates behavioral routines and enables members to be active participants in their own healthcare
  • Provides telephone follow-up to ensure members have seen their PCP and are completing their care management treatment plan or preventive care services as defined by the PCP or guidelines
  • Assists in obtaining benefits for members through community resources when benefits are exhausted or not available
  • Required an Associate's Degree in nursing or graduation from Diploma Nursing School (if RN)
  • Required a Master's Degree in Social Work, Psychology, Counseling, Rehabilitation, or other relevant field that provides a foundation to receive a license as required of the position
  • Required 1+ year of experience in current case management as a licensed professional
  • Required experience working with the needs of vulnerable populations who have chronic or complex bio-psychosocial needs
  • Preferred experience in a managed care environment
  • Intermediate ability to work independently Ability to work independently, handle multiple assignments and prioritize workload
  • Intermediate demonstrated time management and priority setting skills
  • Intermediate demonstrated interpersonal/verbal communication skills; communicates effectively in person and by phone
  • Advanced ability to create, review and interpret treatment plans Ability to create, review and interpret treatment plans
  • Intermediate knowledge of healthcare delivery
  • Intermediate demonstrated customer service skills
  • Required Licensed Clinical Social Worker (LCSW) LSW, LCSW, LMHC, LPC, LMFT, PsyD
  • Required Licensed Master Social Work (LMSW)
  • Required Acute Care Nurse Practitioner (APRN) (ACNP-BC)
  • Required intermediate Microsoft Outlook Proficient in Microsoft Office including Outlook, Word and Excel
  • Required intermediate Microsoft Word Knowledge of or the ability to learn company approved software such as EMMA, CRMS, Peradigm, InterQual, Sidewinder and other software in order to perform job duties
  • Required intermediate Other Knowledge of or the ability to learn company approved software such as EMMA, CRMS, Peradigm, InterQual, Sidewinder and other software in order to perform job duties
2

Behavioral Health Care Manager Tx-irving After Hours Lcsw Resume Examples & Samples

  • Assesses patient's clinical presentation for medical necessity and appropriateness of proposed evaluation/treatment goals
  • Authorizes inpatient and/or outpatient treatment according to company's stated criteria
  • Clearly and completely documents all initial and concurrent reviews, including, but not limited to diagnosis, symptoms, interventions, goals and plan for next review
  • Consults with Providers as needed, responds to provider questions with regard to EAP or Managed Care cases
  • Performs provider recruiting duties as needed
3

Behavioral Health Care Manager Tx-irving Day Shift Lcsw Resume Examples & Samples

  • Closes all cases according to the defined case closure procedure in a timely manner, and in accordance with guidelines established by the department Director
  • Participates in training of other Care Managers as necessary
  • Completes EAP authorizations as assigned
  • Attends weekly Administrative and Peer Review Committee meetings
  • Performs special audits, projects, etc. as required
4

Behavioral Health Care Manager Resume Examples & Samples

  • Prepares for patient interaction by gathering information from reviewing the patient's medical record when available as well as communicating with the primary care physician (PCP) and other clinical team members
  • Identifies all situations involving the patient's needs and works independently with the patient/guardian to rectify and manage those needs. Develops trusting, professional, caring relationships with patients and families, engaging respectfully and with utmost attention to service
  • Communicates effectively with the patient and/or patient representative (guardian) the patient's needs and resources available to meet those needs
  • Assesses crisis intervention needs and acts appropriately to meet those needs
  • Collaborates with the PCP and follows through with the identified plan in a timely manner
  • Communicates with the PCP and team at specific identified times the status of patients at high risk
  • Provides consultation to CM colleagues for patients with BH issues
  • Maintains the current documentation requirements
  • Develops an individualized holistic plan of care for the patient in collaboration with the patient/family/caregiver; performs a psychosocial assessment to determine Behavioral Health Care Management needs and follow-up
  • For each visit/telephonic interaction, demonstrates the skills and judgment necessary to implement the plan of care as well as any interventions or procedures necessary. This is evident by chart review, observation, and patient interaction
  • Experience in a health care setting required
  • Knowledge of and experience with a pediatric/adolescent population
  • Competency in this position is dependent upon the patient population as the position does provide patient care/services
  • Knowledge of disease processes and/or diagnosis
  • Familiarity with guardianship issues
  • Participates in continued learning and possess a willingness and ability to learn and utilize new technology and procedures that will continue to develop in their role and throughout the organization
  • Embraces technological advances that allow SHCN to communicate information effectively and efficiently
5

Behavioral Health Care Manager Resume Examples & Samples

  • 1+ year of prior experience working with Behavioral Health patients
  • Active NYS Registered Nurse (RN) license
  • Previous experience working within an Acute Care and/or Inpatient setting
  • Care / Case Management background
  • Previous experience with Utilization Review or Discharge Planning
6

Behavioral Health Care Manager, RN Resume Examples & Samples

  • Manages members with severe mental illness who have high rates of behavioral health utilization and/or severe psychosocial vulnerability
  • Works towards achievement of optimal clinical and resource outcomes
  • Monitors and evaluates effectiveness of care plan and modifies plan as needed
  • Supports member access to appropriate quality and cost effective care
  • Acts as a liaison and member advocate between the member/family, physician and facilities/agencies
  • Provides clinical consultation to physicians, professional staff and other teams members/supervisors to provide optimal quality patient care and effective operations
  • Interacts continuously with members, family, physician(s), and other resources to determine appropriate behavioral action needed to address medical needs
  • Ensures members are engaging with their PCP to complete their care management treatment plan or preventive care services
  • Master's Degree in Social Work, Psychology, Counseling, Rehabilitation, or other relevant field that provides a foundation to receive a license as required of the position or Registered Nurse with behavioral health background is required
  • Master's level independent or non-independent license OR an RN with a behavioral health background is required
  • Licensed Clinical Marriage & Family Therapist (LCMFT) is required
  • Licensed Clinical Psychologist (LCP) is required
  • Proficient in Microsoft Office including MS Outlook, MS Word and MS Excel is required
  • Healthcare Management Systems (Generic) is required *LI-RG1
7

Behavioral Health Care Manager Resume Examples & Samples

  • Assesses, plans, implements, monitors and evaluates options and services to meet complex psychosocial health needs of inpatient and outpatient members. Manages a caseload in compliance with contractual obligations and WellCare standards
  • Conducts comprehensive member assessments through root cause analysis based on referred member's needs and benefit plan eligibility, and performs clinical intervention through the development of a care management treatment plan specific to each member with high level acuity needs
  • Manages members with severe mental illness who have high rates of behavioral health utilization and/or severe psychosocial vulnerability. Works towards achievement of optimal clinical and resource outcomes
  • Acts as a liaison and member advocate between the member/family, physician and facilities/agencies. Provides clinical consultation to physicians, professional staff and other teams members/supervisors to provide optimal quality patient care and effective operations
  • Interacts continuously with members, family, physician(s), and other resources to determine appropriate behavioral action needed to address medical needs. Reviews benefits options, researches community resources, trains/creates behavioral routines and enables members to be active participants in their own healthcare
  • Required A Master's Degree in Social Work, Psychology, Counseling, Rehabilitation, or other relevant field that provides a foundation to receive a license as required of the position
  • Preferred Other Experience in a managed care environment
  • Required Other A master's level independent or non-independent license is required OR an RN with a behavioral health background
  • Required Other NJ Only - post graduate (master level) LSW
  • Required Intermediate Microsoft Outlook Proficient in Microsoft Office including Outlook, Word and Excel
8

Behavioral Health Care Manager Resume Examples & Samples

  • Required A Master's Degree in Social Work, or Counseling, or other relevant field that provides a foundation to receive a license as required of the position
  • Required Experience working with the needs of vulnerable populations who have chronic or complex bio-psychosocial needs
  • Preferred Experience in a managed care environment
  • Required - A Master's level independent or non-independent license is required
  • In New Jersey, one of the following is Required: Licensed Social Worker (LSW), Licensed Associate Counselor (LAC) or Registered Nurse (RN) with a behavioral health background
  • Preferred - Licensed Clinical Social Worker (LCSW) or Licensed Professional Counselor (LPC)
9

Behavioral Health Care Manager Resume Examples & Samples

  • Contribute to a team oriented environment based on exhibiting the characteristic of positive expectancy
  • Work collaboratively with other members of the Humana Interdisciplinary team, including medical counterparts performing medical case management
  • Comply with performance and reporting standards as defined by Humana
  • Contribute to an increases in scores on Kenexa Engagement surveys and Well-being Index by being actively involved in Impact Planning, and promoting associate engagement and participation, in well-being opportunities
  • Contribute to a production-oriented call center environment with variety of tasks
  • Meet key performance standards including audits, weekly successful closure expectations, and caseload maintenance
  • Understand case management concepts and how these concepts are applied to a member population within a telephonic environment
  • Use your interpersonal skills including proficiency in Motivational Interviewing and Solution Focused Therapy
  • Exercise sound clinical judgment and engage in ethical behavior, including practicing of case management within scope of licensure
  • Understanding members in their current life situation, and develop and implement personalized S.M.A.R.T. goals and treatment plans
  • Conceptualize and present clinical cases in concise and clear manner
  • Provide training and feedback to medical case managers as needed
  • Additional responsibilities as deemed appropriate by Humana leadership
  • Must be available to work 10 – 7 p.m. if located in the CST time zone
  • Master’s degree in healthcare-related field or current licensure as a Registered Nurse
  • Current valid license in state of residence as a Social Worker (LMSW), Professional Counselor (LPC or state equivalent), marriage and family therapist (LMFT), or Registered Nurse (RN)
  • Comfortable working in fast-paced, production-oriented, call center environment handling a variety of tasks
  • Ability to meet key performance standards including audits, successful closures, and caseload maintenance
  • Skilled in balancing and executing on multiple tasks, including caseload management
  • Technical competence with Microsoft Office Programs, e.g. Word, Excel, PowerPoint, and excellent keyboard and web navigation skills
  • Exceptional communication and interpersonal skills including Motivational Interviewing and Solution Focused tools
  • Ability to exercise sound clinical judgment and engage in ethical behavior, including practicing of case management within scope of licensure
  • Ability to meet members in their current life situation, and develop and implement personalized S.M.A.R.T. goals and treatment plans
  • Valid Certified Case Manager (CCM) certification
10

Behavioral Health Care Manager Resume Examples & Samples

  • Assesses, plans, implements, monitors and evaluates options and services to meet complex psychosocial health needs of inpatient and outpatient members
  • Manages a caseload in compliance with contractual obligations and WellCare standards
  • Monitors and evaluates effectiveness of care plan and modifies plan as needed. Supports member access to appropriate quality and cost effective care
  • Coordinates with internal and external resources to meet identified needs of the member's care plan and collaborates with providers
  • Reviews benefits options, researches community resources, trains/creates behavioral routines and enables members to be active participants in their own healthcare
  • Master's Degree in Social Work, Psychology, Counseling, Rehabilitation, or other relevant field that provides a foundation to receive a license as required of the position is required
  • 2+ years of experience in behavioral health management and/or acute behavioral health care setting focusing on outpatient/inpatient utilization, case management and discharge planning is required
  • 1+ year of experience in current case management as a licensed professional is required
  • Experience working with the needs of vulnerable populations who have chronic or complex bio-psychosocial needs is required
  • Experience in a managed care environment is preferred
  • Ability to work independently, handle multiple assignments and prioritize workload
  • Demonstrated customer service skills
  • Master's level independent or non-independent license is required OR an RN with a behavioral health background is required
  • Licensed Clinical Social Worker (LCSW) LSW, LCSW, LMHC, LPC, LMFT, PsyD is required
  • Licensed Clinical Mental Health Counselor (LCMHC) is required
  • Licensed Clinical Professional Counselor (LCPC) is required
  • Licensed Master Social Work (LMSW) is required
  • Certified Social Worker (C-SW) is required
  • Acute Care Nurse Practitioner (APRN) (ACNP-BC) is required
  • Knowledge of or the ability to learn company approved software such as EMMA, CRMS, Peradigm, InterQual, Sidewinder and other software in order to perform job duties is required
11

Behavioral Health Care Manager Lead-indiana Resume Examples & Samples

  • Requires MS or MA in social work, counseling, nursing or related behavioral health field; 5+ years of experience with facility-based and/or outpatient psychiatric and substance abuse or substance abuse disorder treatment; or any combination of education and experience, which would provide an equivalent background
  • Current active unrestricted license as an RN, LCSW, LMSW, LMHC, LPC, LBA (as allowed by applicable state laws), LMFT, or clinical Psychologist, to practice as a health professional within the scope of licensure in applicable states or territory of the United States required
  • Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases required
  • Prior managed care experience required
12

Behavioral Health Care Manager Resume Examples & Samples

  • Conducts all necessary direct utilization management activities for behavioral health plan members including service coordination for members in crisis, crisis intervention, behavioral health triage, crisis assessment services, pre-certification and authorization of care for both psychiatric and chemical dependency services, all necessary concurrent review with hospitals and mental health centers, discharge and aftercare planning and referrals for continued outpatient care
  • Interacts on a daily basis with hospital representatives and attending psychiatrists and coordinates physician-to-physician reviews with the medical director. Reviews treatment plans and consults with medical director regarding medical necessity criteria for continued inpatient stay. Facilitates community placements, agency linkages and coordinates discharge planning, aftercare, referral and follow-up of inpatients
  • Identifies high risk/high volume members for more intensive follow-up care and conducts hand-off coordination between Clinical Coordinators and providers
  • Ensures members have access, availability and quality care according to standards
  • Performs all other clinical and administrative duties as assigned
  • 1+ year clinical behavioral health experience providing direct patient care services
13

Behavioral Health Care Manager Resume Examples & Samples

  • Requires MS or MA in social work, counseling, nursing or a related behavioral health field
  • 3-4 years experience with facility-based and/or outpatient psychiatric and substance abuse or substance abuse disorder treatment; or any combination of education and experience, which would provide an equivalent background
  • Current active unrestricted license as an RN, LCSW, LMSW, LMHC, LPC, LBA (as allowed by applicable state laws), LMFT, or Clinical Psychologist, to practice as a health professional within the scope of licensure in applicable states or territory of the United States required
14

Behavioral Health Care Manager / Consultant Resume Examples & Samples

  • Facilitates implementation of the behavioral health collaborative care model in primary care or subspecialty medical/surgical practice setting
  • Collaborates with clinical and non-clinical practice staff on the performance of behavioral health screening and related processes
  • Serves as a resource to physician and staff by providing guidance and solutions in behavioral health-related processes (screening, treatment algorithms, psychopharmacology principles, escalation, psychiatric consults, etc.)
  • Serves as a liaison with behavioral health service line to facilitate practice adoption of new technologies, including telepsychiatry capabilities
  • Monitors, documents, and follows up on practice behavioral health activities to ensure integration and compliance. Prepares and presents reports to service line leadership
  • Performs psychosocial care management in primary care or subspecialty medical/surgical practice setting
  • Obtains and utilizes patient information to develop a psychosocial care plan to address identified patient needs, as required
  • Coordinates necessary resources to move patient along continuum in a timely manner
  • Monitors patient’s progress and intervenes, as necessary, to ensure care provided are patient focused, high quality, efficient, and cost effective
  • Contributes to healthcare team’s, patient’s and family’s understanding of social and emotional elements of patient’s life related to diagnoses and treatments
  • Collaborates with RNs and RN Care Managers to identify and manage treatment of complicated and high risk cases to foster positive outcomes
  • Provides brief psychotherapeutic services to patients, in accordance with behavioral collaborative care model, as needed
  • Completes documentation in accordance with policies and procedures of the organization, state and federal regulations
  • New York State licensure in one (1) of the following professions, required
  • Licensed Master Social Worker (LMSW)
  • Licensed Mental Health Counselor (LMHC)
  • Licensed Psychologist
15

Behavioral Health Care Manager Resume Examples & Samples

  • Required A Master's Degree in clinical social work, psychology, counseling, rehabilitation etc. (if LSCW)
  • Required 1+ year of experience in clinical behavioral health experience providing direct patient care services
  • Preferred Other Experience providing care management or utilization management services in a managed behavioral health organization, community mental health center, health plan or hospital
  • Required Intermediate Microsoft Outlook Ability to communicate on any level required to meet the demands of the position
16

Behavioral Health Care Manager Resume Examples & Samples

  • Intermediate demonstrated interpersonal/verbal communication skills Communicates effectively in person and by phone
  • Required intermediate Microsoft Office including Outlook, Word and Excel
  • Required Intermediate ability to learn company approved software such as EMMA, CRMS, Peradigm, InterQual, Sidewinder and other software in order to perform job duties
17

Behavioral Health Care Manager Lcsw Resume Examples & Samples

  • Screen: Identifies patients and their needs utilizing specific screening criteria. Maintains an effective Care Management program through early identification of members requiring Care Management
  • Assess: Gathers all relevant data and obtains information by interviewing the patient/family/significant other and performs an evaluation. Evaluates all relevant information to identify barriers, determines realistic goals and objectives and seeks potential alternatives. Authorizes appropriate behavioral health services. Completes and follows up on any notifications as directed by Intake Coordinators. Calls the initiating individual with approval or denial status
  • Plan: Works with the member, family/significant other, physician and other health care providers to develop a plan or plans of care that optimizes member outcomes. Initiates and implements plan modifications as necessary through monitoring and re-evaluation to accommodate changes in treatment or progress. Evaluates quality and appropriateness of inpatient and outpatient care. Directs members to appropriate facilities. Performs cost-benefit analysis and negotiates rates with providers and vendors. Assures that benefits, funding and/or community resources are available to implement the plan and coordinates appropriate use of resources and level of services. Notifies appropriate management of any large claim, high-risk members who are requiring, or will require, intensive and/or costly services
  • Facilitate: Actively communicates and collaborates between all team members, member/family/significant other and providers to enhance and maximize outcomes. Minimizes or eliminates unnecessary steps, promotes timely provision of care and promotes efficient use of resources. Compares the member's course to an established clinical pathway to determine variances
  • Advocate: Ensures the member?s individualized needs and goals are incorporated throughout the care management process. Supports and educates the member to become empowered, self-reliant and a self advocate. Represents the member?s best interest through advocacy for necessary funding, treatment alternatives, timeliness, coordination of health services and frequent re-evaluation of progress and goals
  • Triage/Referral and Utilization Management: Maintains consistent availability to triage and referral staff. Makes referral and triage decisions that require clinical staff management. Assists to ensure staff are consistent with application of approved criteria. Assists to ensure that UM decisions are made in a timely manner and pursuant to policy
  • Other Job Related Responsibilities: Maintains a knowledge base of current medical and mental health policies, procedures and services, SelectHealth's plan designs and paneled providers and all applicable NCQA guidelines. Assists with implementing department improvement plans as they relate to member satisfaction regulatory body requirements and financial performance. Participates in staff training. Participates in monitoring of documentation adequacy. May participate on committees to improve care process models, evaluate opportunities for appropriate cost containment and improve member satisfaction
18

Behavioral Health Care Manager Resume Examples & Samples

  • MS or MA in social work, counseling, nursing or a related behavioral health field
  • 3 years’ experience with facility-based and/or outpatient psychiatric and substance abuse or substance abuse disorder treatment; or any combination of education and experience, which would provide an equivalent background
  • Current active unrestricted license as a RN (Psychiatric), LCSW, LMSW, LPC, LMFT, LMHC, or Clinical Psychologist to practice as a health professional within the scope of licensure in the state of New York
  • Experience working with electronic databases, multiple PC’s, and data entry
  • Experience with ABA Services a plus
19

Behavioral Health Care Manager Resume Examples & Samples

  • Graduate degree from an accredited educational program in Social Work, Clinical/Counseling Psychology, or Nursing. Direct practice in a Children’s Behavioral Health Level of Care ( ie. BHRS, FBMHS, RTF, etc)
  • Minimum three years post graduate clinical experience or equivalent combination of education and clinically related work experience. Minimum one year experience working with a managed care system. Minimum one year experience in Behavioral Health Service Delivery System. Knowledge base in Medicaid, Medicare and Commercial Managed Care Systems
  • Ability to provide constructive feedback with a focus on improved quality
20

Behavioral Health Care Manager Resume Examples & Samples

  • Minimum two years of experience in behavioral health setting
  • Must be able to prioritize work and develop strategies for adapting to constantly changing priorities and urgencies
  • Demonstrate cultural competency and sensitivity
  • Experience with Motivational Interviewing and/or Health Coaching a plus
  • Comfort with End of Life and Goals of Care discussions
  • Experience or background in Behavioral Health a plus
21

Behavioral Health Care Manager Resume Examples & Samples

  • Current unrestricted license as an LCSW, LMHC, LPC (LPC as allowed by applicable state laws), Marriage and Family Therapist, or clinical Psychologist required
  • Requires a MS in social work, counseling or a related behavioral health field
  • Requires at least 3 years of experience with facility-based and/or outpatient psychiatric and chemical dependency treatment; or any combination of education and experience, which would provide an equivalent background
  • Previous experiences in case management/utilization review preferred