Remote RN Care Manager

Remote RN Care Manager

22 Sep 2024
Florida, Orlando, 32801 Orlando USA

Remote RN Care Manager

Vacancy expired!

Job Description

Clinical Appeals RN, must hold an Idaho State RN License

Qualifications

  • Required:

  • Three years’ clinical nursing experience to include:

    oOne year utilization management or discharge planning; and

    oMedical and surgical inpatient and/or outpatient care;

    or

    oSpecialty care (occupational health, rehabilitation, orthopedic, neurological surgical nursing, or behavioral health)

  • Active Idaho or Compact RN License
  • Must Have Knowledge in:

  • Managed care delivery systems including but not limited to member benefit application, provider payment methodologies and evidence-based criteria
  • Proficient understanding of benefits and contract requirements related to the lines of business included in the National Commission on Quality Assurance (NCQA) accreditation
  • Proficient understanding of Center for Medicare and Medicaid Services (CMS) benefits, regulations and reporting criteria
  • Group process and team dynamics
  • Utilization Management
  • Quality Improvement
  • National Commission on Quality Assurance (NCQA) accreditation standards

Additional Information

All your information will be kept confidential according to EEO guidelines.

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Job Details

  • ID
    JC20085222
  • State
  • City
  • Job type
    Full-time
  • Salary
    N/A
  • Hiring Company
    Greenkey Resources
  • Date
    2021-09-22
  • Deadline
    2021-11-21
  • Category

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