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Form of workJob Description
Registered Nurse Case Manager
Job description
Third Party Administrator Provider is seeking a Registered Nurse Case Manager. Clinical experience required.
Primary Duties will include:
Use Milliman criteria used for utilization reviews
- Pre Certification Authorizations and Reviews.
- Review large medical hospital claims for accuracy and necessity.
- Telephone Communications with providers and patients.
- Review of pre-treatment notification requests.
- Concurrent Clinical review/audit of hospital admission records and charts.
- Review case history for medical necessity.
Full-Time M-F, In-Office position with excellent benefits and competitive salary for an Experienced Registered Nurse.
Job Type: Full-time
Job Type: Full-time
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Schedule:
- 8-hour shift
Work setting:
- Office
Education:
- Bachelor's (Required)
Experience:
- Nursing: 1 year (Required)
License/Certification:
- Registered Nurse License (Required)
Work Location: In person
