Registered Nurse Case Manager

2 months ago


Kalamazoo, United States Company Name Withheld Full time
Job DescriptionJob 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

 



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