Job Summary
A health insurance company needs applicants for an opening for a Telecommute Long Term Care Services Nurse Medical Manager I in New York City.
Individual must be able to fulfill the following responsibilities:
- Conduct pre-certification, concurrent review, or care coordination
- Ensure member access to medical necessary, quality healthcare in a cost effective setting according to contract
- Work with medical directors in interpreting appropriateness of care and accurate claims payment
Qualifications for this position include:
- Must reside within reasonable commute to the company office in the State of New York
- Requires current active unrestricted RN license to practice as a health professional within the scope of practice in the State of New York
- 2 years acute care clinical experience
- Experience with Health Commerce System
- Active New York State Driver's License or State ID (for security purposes to access Health Commerce System)
