Job Summary
A healthcare company is seeking a Remote Nurse Care Manager II.
Must be able to:
- Ensure medically appropriate, high-quality, cost-effective care through assessing the medical necessity of inpatient admissions and extensions
- Partner with physician clinical reviewers and/or medical directors to interpret appropriateness of care
- Conduct clinical assessment to develop goals that address individual needs in order to develop and implement a care plan
Skills and Requirements Include:
- Requires 3 years of acute care clinical experience, condition-specific clinical experience, home health/discharge planning experience
- At least 1 year in a Nurse Care Mgr I role or equivalent experience
- Current, unrestricted RN license in applicable state(s) required
- Must have excellent interpersonal skills
- Must have knowledge of medical management process and ability to interpret and apply member contracts, member benefits, and managed care products
