Technical knowledge of statutory regulations and medical terminology. Excellent written and verbal communication skills, including ability to convey technical details to claimants, clients and staff. Ability to interact with persons at all levels in the business environment.
Active unrestricted Resident OR Non-Resident RN license in state of CA. Minimum of 1 year recent health plan case/care management experience. Knowledge of health and/or patient education and behavioral change techniques. Strong computer technical skills.
Analyze complex or technically difficult medical malpractice claims. Manage the total claim costs while providing high levels of customer service. Communicate claim activity and processing with the client and maintain professional client relationships. Position Requirements Include: