Registered Nurse Care Coordinator

Job Summary

A company is looking for a Care Coordinator - FEP RN.

Key Responsibilities

• Perform medical necessity reviews for inpatient and outpatient services
• Consult with Medical Directors regarding care that does not meet criteria
• Document clinical information accurately and timely while meeting production and quality metrics

Required Qualifications

• Bachelor's degree or four years of relevant work experience
• Current State Licensure as a registered nurse
• Three years of clinical experience
• Experience in Utilization Management
• Experience in the health plan industry