Job Summary

A health care provider has an open position for a Remote Utilization Management Care Manager.

Individual must be able to fulfill the following responsibilities:

• Obtain documentation to support requested level of care within the defined health plan regulatory timeframes
• Document all activities in the Health Plan's care management tracking system following Health Plan and internal department standards
• Review and document clinical information from health care providers

Qualifications Include:

• Minimum of 2 years of experience in clinical and/or case management nursing
• Minimum of 1-year work-related experience in Utilization Management
• Strong organizational, task prioritization and problem-solving skills
• Ability to construct grammatically correct reviews using standard medical terminology
• Computer proficiency required