Job Summary
A health insurance company is in need of a Remote Nurse Medical Manager I or II.
Candidates will be responsible for the following:
- Ensuring medically appropriate, high quality, cost effective care
- Applying clinical knowledge to ensure medical necessity of billed service
- Ensuring member benefits are correctly applied to claims payment
Skills and Requirements Include:
- 2 years clinical RN experience
- Experience working with Microsoft Office (Outlook, Excel, and Word)
- Experience using electronic documentation and using multiple computer screens
- Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills
- Medicare, Medicaid &/or Medicare Supplement review experience required