An insurance company is searching for a person to fill their position for a Remote Registered Nurse Utilization Management Nurse Consultant. Core Responsibilities Include: Communicating with providers and other parties. Gathering clinical information.
A health insurance and wellness company has a current position open for a Telecommute Care Management Nurse 2. Individual must be able to fulfill the following responsibilities: Manage a member's health issues. Identify and resolve barriers that hinder effective care.
2+ years of acute hospital clinical experience. 4+ years of utilization management experience. Current RN license in NewJersey and any other compact states. Knowledge of current standard of medical practices and insurance benefits. Familiarity with Milliman and InterQual guidelines.
This position is a Field opportunity. Must possess an active, unencumbered license in state of residence and the State of NewJersey. Registered Nurse. Required to become CHCQM certified by the ABQAURP within one year of hire. Minimum 1-year prior case management experience.