Registered Nurse - Case Manager - 164601- MK (22540154)
· Requires current state of Indiana license as a Registered Nurse.
· Certification in Case Management preferred.
· Knowledge of InterQual Acute Level of Care Criteria and Federal guidelines outlining coverage of inpatient and outpatient hospital services, including observation is preferred.
· Knowledge of Medicare/Medicaid, insurance and regulatory guidelines is preferred.
· Ability to comprehend third party contractual arrangements is preferred.
· Understanding of the third party denial and appeal process is preferred.
· Requires knowledge of various software applications including Windows; Cerner; MCCM; and SMS.
· 3-5 years of experience required.
· Requires strong clinical background in acute care.
I’m available anytime between 10 AM EST to 6 PM EST.