Offer summary
Qualifications:
Bachelor’s Degree in Nursing or equivalent, 3 years related experience in acute care or health insurance, 2 years experience in pre-authorization and care coordination, Current unrestricted RN licensure.
Key responsabilities:
- Evaluate and approve requested services following guidelines
- Manage cases for medical necessity reviews
- Document information accurately in UM system
- Assist in identifying care management needs for members
- Collaborate with internal and external partners