Job Summary
An insurance company is searching for a person to fill their position for a Remote Transplant Nurse l or ll.
Core Responsibilities Include:
- Collaborating with healthcare providers and members to promote quality member outcomes
- Conducting precertification / predeterminations
- Consulting with clinical reviewers to ensure member access to medically necessary, quality healthcare
Qualifications for this position include:
- Current unrestricted RN license in the state of residence
- Ability to comprehend medical policy and criteria to clearly articulate health information
- Broad clinical knowledge base of disease processes
- Ability to interpret and analyze medical information
- Knowledge of case management assessment techniques and health care service providers
