Coordinating utilization and case management activities, the full-time Remote Registered Nurse Medical Management Coordinator will manage outpatient service reviews, facilitate clinical discussions, and maintain compliance with HIPAA guidelines while supporting the RHP Medical Management Committee. Key responsibilities Oversee delegated Utilization Review activities for SRHS Health Plan and coordinate outpatient service reviews Facilitate discussions with the RHP Medical Director regarding clinical reviews and manage member/customer requests and complaints Maintain documentation and databases in compliance with URAC standards and communicate results of reviews to Third Party Administrators Required qualifications Current Registered Nurse license Minimum of 5 years of clinical experience At least 3 years of experience in Utilization Management or Case Management Valid driver's license with a good driving record Ability to adapt to changes in the work environment and manage competing demands
Registered Nurse Medical Management Coordinator in workfromhome at Unknown Company
- Typical pay
- $71,760–$113,550
For context, most registered nurses earn between $71,760–$113,550 a year according to Bureau of Labor Statistics wage data. What this particular role pays is set by the employer — check the description above.
This position is listed as full time and able to be worked remotely.