Remote Nurse Medical Management I II Sr

Location: Nationwide

Compensation: To Be Discussed

Staff Reviewed: Tue, Jan 05, 2021

This job expires in: 11 days

Job Category: Healthcare

Remote Level: 100% Remote

Weekly Hours: Full Time

Employer Type: Employer

Career Level: Experienced

Job Summary

A health insurance company has an open position for a Remote Nurse Medical Management I II Sr.

Candidates will be responsible for the following:

  • Conduct pre-certification, continued stay review, care coordination, or discharge planning for appropriateness of treatment
  • Ensure member access to medical necessary, quality healthcare in a cost effective setting according to contract
  • Consult with clinical reviewers and/or medical directors to ensure medically appropriate, high quality, cost effective care

Qualifications Include:

  • Requires current active unrestricted RN license to practice as a health professional within the scope of practice in applicable state(s) or territory of the United States
  • AND 2 years acute care clinical experience
  • Requires strong oral, written and interpersonal communication skills
  • Requires problem-solving skills, facilitation skills, and analytical skills
  • Must have high speed internet connection
  • Must be self-motivated, professional, organized, with attention to detail

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