Tennessee Licensed Medical Management Manager

Job Summary

A company is looking for a Manager of Medical Management to oversee teams delivering home health and durable medical equipment services for Medicaid members.

Key Responsibilities

• Manage prior authorization for home health and DME services
• Provide oversight of home health case managers supporting medically complex members
• Ensure timely delivery of medically necessary in-home services and supports

Required Qualifications

• 3 years of Utilization Management or Case Management experience required
• 5 years of experience in the Health Insurance Industry
• 3 years of experience in a management or supervisory/team lead capacity
• Active Registered Nurse (RN) license in Tennessee or ability to secure it immediately upon selection
• Extensive knowledge of Utilization Management, Care Management, and Behavioral Health