Medical Management Nurse - RN

POSITION SUMMARY:

This position is responsible for ensuring medically appropriate, high quality, cost effective care throughout the utilization review process within a dedicated network.

 KNOWLEDGE, SKILLS, & ABILITIES:

• Excellent verbal and written skills
• Strong clinical background
• Basic mathematical and statistical ability
• Basic computer knowledge
• Must be well organized
• Understanding of quality improvement process
• Ability to work well under pressure and handle multiple tasks
• Ability to work independently or with others (physicians, healthcare staff, etc.)

QUALIFICATIONS:

• Associates degree or diploma
• Valid Indiana State Registered Nurse License

EXPERIENCE/TRAINING:

• 2-4 years of clinical nursing experience.
• 2-4 years of related utilization management/managed care experience - preferred
• Medicare/Medicaid experience helpful