A provider of medical managed care services has a current position open for a Telecommute Medical Nurse Case Manager. Candidates will be responsible for the following: Helping coordinate the individual’s treatment program. Ensuring quality, cost-effective care.
Qualifications Include: Participates in utilization management activities. Minimum of 5 years of experience conducting utilization management. Registered Nurse. FL Licensure required. Knowledge of medical utilization management procedures. Must meet all other listed company requirements.
Present complex cases to the Medical Director at tri-weekly team meetings. Minimum 7 years prior experience in Oncology Care. Masters Degree in Nursing or a health related field. Oncology Nursing Certification from the ONCC. Strong knowledge of oncology and insurance industry.
A healthcare company is in need of a Remote HEDIS Medical Records Review Nurse. Individual must be able to fulfill the following responsibilities: Contact provider offices to establish appointment times. Complete comprehensive and thorough medical record reviews.
A healthcare company is seeking a Remote Medical Field Case Manager. Must be able to: Implement and coordinate all case management activities. Interact with members/clients telephonically or in person. Provide educational and prevention information for best medical outcomes. Required Skills:
A medical review company is in need of a Remote Claims Quality Analyst Nurse. Must be able to: Review reports accompanying medical records. Work with a sense of urgency and meet deadlines. Ensure clarity of information and to ensure all questions posed have been addressed.
Navigating hospitals medical record system. Performing a variety of audit services. Must meet the following requirements for consideration: Must demonstrate the ability to read a medical chart and hospital itemized bills. Understanding of hospital charging policies.
Completing comprehensive and thorough medical record review. Contacting provider offices to establish appointment time. Qualifications for this position include: Remote plus travel. 3+ years of experience in acute healthcare setting. Associates Degree in a healthcare related field.
Qualifications Include: Remote work following a 1 day training session at a local site. 3 years hospital experience from: medical-surgical, neuro, intensive, ER, step-down or progressive, telemetry. Ability to start as early as March 4
Individual must be able to fulfill the following responsibilities: Utilize clinical nursing skills to support the coordination, documentation and communication of medical services. Work assignments are varied and frequently require interpretation and independent determination.