Job Summary

A health insurance company is searching for a person to fill their position for a Telecommute Nurse Medical Management I or II in Alexandria.

Individual must be able to fulfill the following responsibilities:

• Conduct precertification, continued stay review, care coordination, or discharge planning
• Consult with clinical reviewers and/or medical directors to ensure medically appropriate, high quality, cost effective care
• Facilitate member care transition through the healthcare continuum

Qualifications 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, utilization management or managed care experience
• Must have knowledge of medical management process and ability to interpret and apply member contracts, member benefits, and managed care products
• Requires strong oral, written and interpersonal communication skills