Acupuncture Case Review

Location: Sacramento , CA

Date Posted: 02/11/2014

An Acupuncture Case Manager (ACM) is a clinical peer reviewer primarily responsible for performing utilization review of acupuncture services provided to members. ACMs act as a liaison to member acupuncture practioners, their staff, and clients. They are accountable for analyzing and investigating high-risk or suspicious claims. ACMs monitor practitioners for unusual and/or exceptional treatment patterns, and serve as an informational resource for Case Management and other departments.

This position is a part time, telecommuting position (work from your home or office) of approximately 10 hours per week.

The candidate must hold a valid, profession–specific degree from a nationally accredited college.
Must maintain a continuously active professional license from any state within the United States and have no outstanding liability cases or pending problems with the State Board of Examiners or any other federal or state regulatory agency.
Must have minimum practice experience of two (2) years.

Strong written and verbal skills for communication to directors, management, clients, practitioners, patients, staff, and the community regarding conflict resolution, relaying concepts, and providing one-on-one training. Must have the ability to clearly communicate the principle reasons for treatment plan modifications or denials of requested services and where requested the clinical rationale for the decision.
Must handle confidential information pursuant to all internal controls and federal and state laws governing such information, including those governed by HIPAA.
Working knowledge and experience in personal computer software programs required. Experience in a Microsoft Office environment preferred.

Landmark Healthcare, A CareCore National Company
Contact Information:
Contact Name: Human Rescources, Phone: (916)569-3370