50-50 remote work vs on-site and travel within 30-minute radius of DC. 3+ years clinical RN experience. Case/Care management experience with multiple concurrent accounts/cases. High level competency with MS Office, especially Excel. Current RN license required.
Evaluating clinical documentation on multiple patient accounts and escalating issues. Reporting insurance denial trends identified during daily operational assignments. Working post discharge prebill accounts to resolve accounts with no auth numbers. Qualifications for this position include:
Case Manager certification desired. Minimum of one (1) year experience as a case manager in a health plan or Accountable Care Organization (ACO) or other comparable required. Three (3) years clinical experience in an acute care setting required.