Rn - Remote Eligible

✨ About The Role

- The RN will collaborate with other healthcare providers to review medical care and services against established CMS Coverage Guidelines and NCQA review criteria. - The role involves working in a fast-paced environment, requiring the ability to adapt to multiple time zones. - Experience with physical therapy, DME, home health, cardiac, or orthopedic procedures is desirable. - The position is part of a team that focuses on delivering excellent service to others, emphasizing proactive and preventive care for seniors. - The job may involve utilization management within the insurance industry, particularly in Medicare Advantage or Medicare contexts.

⚡ Requirements

- The ideal candidate will possess an active RN license and the ability to obtain a Compact Nursing License. - A minimum of three years of clinical RN experience is required, with a preference for those with managed care or utilization management experience. - Strong written and verbal communication skills are essential for collaborating with healthcare teams and forming positive relationships with customers. - The candidate should demonstrate emotional maturity and the ability to work independently as well as within a team setting. - Attention to detail and strong computer skills, including proficiency in Microsoft Office products, are necessary for success in this role.