Qualifications:

Required:

• RN with a valid unrestrictive license from state employed in state providing services.
• Two (2) years clinical nursing experience.
• One (1) year previous experience in Managed Care Utilization Management, Medical Management, Case Management.

   Preferred:

• Two (2) years’ experience and knowledge of HMO, PPO, TPA, PHO and Managed Care functions including understanding of claims administration, including CPT-4 codes, revenue codes, HCPCS codes, DRGs, etc.
• Two (2) years’ experience in Managed Care Utilization Management, Medical Management, Case Management
• BSN
• Certified Case Manager (CCM) Certification.

• Schedule: Full-time
• Requisition ID: 24002801
• Daily Work Times: 8:00 am - 5:00 pm
• Hours Per Pay Period: 80
• On Call: No
• Weekends: No