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Telephonic RN Case Manager
Job Summary
A company is looking for a Call Center Nurse/Telephonic RN Case Manager.
Key Responsibilities
- Manage an assigned caseload, including assessment, education, and care coordination for members via telephone
- Handle inbound and outbound calls to authorize tests and procedures related to members' health conditions
- Prepare comprehensive reviews for medical appeals and communicate results to members
Required Qualifications
- Current RN license or eligibility for licensure in the relevant state
- 4+ years of clinical experience
- Experience with Microsoft Office programs
- Ability to work independently and as part of a team
- Experience in implementing critical thinking and decision-making skills for care/treatment plans
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COMPLETE JOB DESCRIPTION
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