Case Manager - Registered Nurse - Philadelphia, PA - Remote - Contract - $45.12 Per Hr

Title: Case Manager - Registered Nurse

Location: Philadelphia, PA (Remote)

Employment Type: Contract

Compensation

Pay Range:$45.12 Per Hr

Summary

• This role involves coordinating care management activities to ensure medical necessity and compliance with regulations.
• The position is remote, based in Philadelphia, PA, and is offered on a contract basis.
• The coordinator will utilize medical guidelines to review clinical conditions and interact with providers to obtain necessary information.
  
  

Requirements

• Advanced medical knowledge and critical thinking skills.
• Experience in evaluating clinical conditions through medical records review.
• Ability to interact with providers for clinical information.
• Knowledge of regulatory compliance with federal and state regulations.
• Experience in patient advocacy and healthcare system navigation.
• Proficiency in utilizing medical criteria for service determination.
• Ability to maintain accurate data entry and documentation.
  
  

Qualifications

• Must be PA, NJ or DE State Licensed Registered Nurse
• Experience in care management or a related field.
• Familiarity with medical criteria guidelines.
• Strong decision-making and judgment skills.
• Excellent communication skills for provider interaction.
• Detail-oriented with strong organizational skills.
• Ability to work independently and as part of a team.
• Proficient in data entry and maintaining system integrity.
  
  

Contact Authorization

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