Telephonic RN Case Manager

Job Summary

A company is looking for a Call Center Nurse/Telephonic RN Case Manager.

Key Responsibilities

• Manage an assigned caseload, including assessment, education, and care coordination for members via telephone
• Handle inbound and outbound calls to authorize tests and procedures related to members' health conditions
• Prepare comprehensive reviews for medical appeals and communicate results to members

Required Qualifications

• Current RN license or eligibility for licensure in the relevant state
• 4+ years of clinical experience
• Experience with Microsoft Office programs
• Ability to work independently and as part of a team
• Experience in implementing critical thinking and decision-making skills for care/treatment plans