DESCRIPTION:
One of America’s premiere managed medicaid companies has created a ground-floor career opportunity. This is a chance to join a major corporation yet still impact the daily care of the needest people. You’ll get to learn managed care operations practice your clinical skills and become an expert patients turn to without working in direct patient care. Based in Columbia SC you’ll enjoy office hours in a comfortable modern office setting a comprehensive corporate benefits plan a competitive salary with bonus and the knowledge that you are impacting the quality of care for thousands of people daily.

As a Case Manager Prior Authorization RN your responsibilities will include but not be limited to the following:
- review requests for prior authorization for radiology services MRI?s CAT Scans etc.
- Act as clinical resources to referral staff and make appropriate referrals.
- Provide patient and provider education.
- Enters authorizations into the system

REQUIREMENTS:
- MUST be an RN
- Bachelor’s Degree in Nursing or other clinical degree
- At least two years clinical nursing experience
- Utilization Management UM certification preferred
- Experience in health care operations.
- Understanding of medical mgmt is very helpful

***** They will consider a candidate with no managed care IF they have strong discharge planning and or chart review and EXCELLENT track record overall.*************

THE COMPANY:
Our client is a leading multi-line health care enterprise that provides programs and related services to individuals receiving benefits under Medicaid including Supplemental Security Income SSI and the State Children?s Health Insurance Program SCHIP . The Company operates health plans in several states.

KEYWORDS: Case manager case management RN nurse CCM certified case manager utilization management utilization review UR UM managed care health plan health insurance

By applying to this position you are agreeing to receive additional information from our firm and our periodic email newsletter about new opportunities and career information. Your personal information is NEVER released to any third parties.

Tags: Registered Nurse

This entry was posted on Thursday, May 21st, 2009 at 5:00 pm and is filed under Job Listings. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.