Remote Nurse Medical Management I and II

Job Summary

A healthcare company has a current position open for a Remote Nurse Medical Management I and II.

Core Responsibilities of this position include:

• Servicing our Medicaid members in the eastern region
• Promoting quality member outcomes
• Conducting pre-certification, continued stay review and care coordination

Qualifications Include:

• Ability to interpret and apply member contracts, member benefits, and managed care products
• Requires a current, active, unrestricted RN license from the state in which you reside
• 3 years of acute care clinical experience
• Requires knowledge of the medical management process
• 2 years of utilization review experience is required for Nurse Medical Mgmt II
• Must be competent in Microsoft Word, Excel, and Outlook