Job Summary
A health insurance company has an open position for a Remote Medical Management Registered Nurse I or II in Cartersville.
Must be able to:
- Conduct precertification, continued stay review, care coordination, or discharge planning
- Ensure medically appropriate, high quality, cost effective care
- Collaborate with providers to assess member’s needs
Must meet the following requirements for consideration:
- Requires current active unrestricted RN license to practice as a health professional
- 3-5 years acute care clinical experience or case or utilization management or managed care experience
- Ability to interpret and apply member contracts, member benefits, and managed care products
- Must have knowledge of medical management process
