Telecommute Nurse Medical Manager II

Job Summary

A health insurance company needs applicants for an opening for a Telecommute Nurse Medical Manager II.

Core Responsibilities of this position include:

• Conducting precertification, continued stay review, care coordination, or discharge planning
• Ensuring member access to medical necessary, quality healthcare in a cost effective setting according to contract
• Facilitating member care transition through the healthcare continuum

Qualifications Include:

• Requires current active unrestricted RN license to practice as a health professional
• 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, problem-solving skills, facilitation skills, and analytical skills