Job Summary

A health insurance company is seeking a Remote Nurse Medical Management Leader in Astoria.

Must be able to:

• Conduct precertification, continued stay review, care coordination, or discharge planning
• Ensure member access to medical necessary, quality healthcare
• Provide continued stay review and care coordination

Required Skills:

• Requires current active unrestricted RN license to practice as a health professional
• Must have knowledge of medical management process
• Prior managed care experience
• Ability to interpret and apply member contracts, member benefits, and managed care products