Clinical Case Manager

3 days ago


Albany, New York, United States National Guard Employment Network Full time
Job Summary

We are seeking a highly skilled Clinical Case Manager to join our team at the National Guard Employment Network. In this role, you will be responsible for conducting in-house utilization review to determine medical necessity for prospective, concurrent, retrospective and appeal treatment requests for workers' compensation claims.

The successful candidate will have a strong background in healthcare, excellent communication skills, and the ability to work effectively in a fast-paced environment. They should also be able to interpret medical records, evaluate treatment plans, and make informed decisions regarding medical necessity.

Key Responsibilities:
  • Conduct in-depth reviews of medical records and treatment plans.
  • Evaluate the medical necessity of treatment requests.
  • Develop and implement effective treatment plans.
  • Maintain accurate records and reports.
  • Communicate with healthcare providers and other stakeholders.


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