Bilingual Japanese RN Clinical Care Manager

Job Summary

A company is looking for a Global Insurance Clinical Care Manager - Bilingual Japanese RN - Remote.

Key Responsibilities:

• Perform prospective, concurrent, and retrospective reviews and non-urgent travel requests for Global Expat members
• Communicate with members and providers to obtain necessary information for clinical reviews and assist Clinical Health Managers with member outreach
• Participate in fraud investigations and identify fraudulent clients and claims

Required Qualifications:

• Registered Nurse with an active unrestricted United States license
• Bilingual in Japanese and English
• 3+ years of experience in medical-surgical inpatient acute care
• Experience in Clinical Coverage Review, Medical Claim Review, or Clinical Appeals
• Ability to work in the Eastern time zone (EST) and adjust schedule as needed