Clinical Finance Case Manager - RN

Job Summary

A company is looking for a Manager, Clinical Finance Case Management-RN.

Key Responsibilities

• Oversee daily operations of Clinical Pre-Certification, Peer to Peer Clinical Appeals, and Denial Analysis
• Utilize clinical knowledge to interpret medical necessity guidelines and determine appropriate levels of care
• Develop and implement policies, procedures, and workflows related to clinical financial case management

Required Qualifications

• Bachelor's degree in nursing with a current license
• Minimum of 5 years of clinical care experience
• Experience collaborating with physicians and their designees
• Extensive knowledge of clinical operations and patient flow
• Proficient in Microsoft Office products and various technology applications