The facility in Denver seeks 2 F/T RN Case Managers for excellent contract working in Managed Care department.
Must have BSN, 3 years' experience in medical utilization management, and experience working with a health insurance plan.
Managed Care experience is preferred however hospital experience is also considered.
Seeking highly skilled individual with experience with InterQUal and MCG.
Provides medical and/or behavioral health utilization management for members of facility medical plan in accordance with the schedule of benefits and network criteria defined by the Plans various lines of business and Center for Medicare & Medicaid Services.