Behavioral Health Case Mgr - CT08IE
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Monitors the medical treatment to ensure quality, effective, and cost-efficient care. Conducts comprehensive evaluations of disability claimants' functionality via functional assessments. Independently reviews and interprets clinical information and utilizes established clinical guidelines and protocols .Drives the crisis support initiative for the disability organization by assessing crisis situations and initiating the threat protocol process when deemed clinically appropriate. Advises on highly complex claims at multidisciplinary clinical review roundtables to ensure optimal outcomes. Determines when claims contain quality of care issues and escalates these through es...