Job Summary
A health insurance company has a current position open for a Remote Registered Nurse Utilization Manager in New York City.
Must be able to:
- Conduct pre-certification, continued stay review, care coordination, or discharge planning
- Ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts
- Ensure member access to medical necessary, quality healthcare in a cost effective setting according to contract
Skills and Requirements Include:
- A current, active unrestricted RN license, from the state of New York, is required
- New York or New Jersey residency is required
- Experience with the Health Commerce system is required
- 2 years acute care clinical experience is required
- Managed care experience required
- You must be competent in Microsoft Word, Excel, and Outlook
