Job Summary
A healthcare and health insurance company has an open position for a Telecommuting Registered Nurse Medical Manager I.
Core Responsibilities of this position include:
- Promote effective use of resources for more complex medical issues
- Collaborate with healthcare providers and members to promote quality member outcomes
- Ensure medically appropriate, high quality, cost effective care through assessing the medical necessity
Qualifications for this position include:
- Requires a current active unrestricted RN license to practice as a health profesional
- Ability to interpret and apply member contracts, member benefits, and managed care products
- Must have knowledge of the medical management process
- Minimum of 2 years acute care clinical experience or case management, utilization management or managed care experience
- Computer literate in MS Office and web-based applications