Job Summary
A health insurance provider is seeking a Telecommute Medical Management Nurse I or II in Richmond.
Must be able to:
- Conduct precertification, continued stay, care coordination, or discharge planning for treatment setting reviews
- Facilitate member care transition through the healthcare continuum and refers treatment plans
- Collaborate with providers to assess member’s needs for early identification of discharge planning
Skills and Requirements Include:
- Requires current active unrestricted RN license to practice as a health professional in applicable state
- 3-5 years acute care clinical experience or case management
- Knowledge of medical management process and ability to interpret and apply member contracts
- Requires problem-solving skills, facilitation skills, and analytical skills
- Ability to respond to more complex medical issues, and serve as resource to lower-leveled nurses
