Job Title: RN - Managed Care Administration
The facility in Denver seeks 2 F/T RN Case Managers for excellent contract work in the Managed Care department.
Minimum Requirements:
- Must have BSN.
- 3 years' experience in medical utilization management.
- Experience working with a health insurance plan.
- Managed Care experience is preferred; however, hospital experience is also considered.
- Experience with InterQual and MCG is required.
Responsibilities:
Provides medical and/or behavioral health utilization management for members of the facility medical plan in accordance with the schedule of benefits and network criteria defined by the Plan's various lines of business and Center for Medicare & Medicaid Services.
#J-18808-Ljbffr
