Massachusetts Licensed RN Care Manager

Job Summary

A company is looking for a Utilization Management Care Manager, RN.

Key Responsibilities

• Review authorization requests for medical services and determine eligibility and coverage
• Manage incoming requests for procedures and services, including patient medical records
• Adhere to performance metrics and maintain effective relationships with internal and external customers

Required Qualifications

• Associate's Degree in Nursing required; Bachelor's Degree preferred
• Current MA Registered Nurse (RN) license required
• 3-5 years of utilization management experience preferred
• UM certification (InterQual) preferred
• 1-2 years of experience in a payer setting preferred