Clinical Nurse Case Manager – USRN
4 weeks ago
At Nezda Technologies Inc., we are seeking a skilled Clinical Nurse Case Manager to join our team.
As a Clinical Nurse Case Manager, you will be responsible for conducting medical management review activities, ensuring member access to medically necessary healthcare in a cost-effective setting.
Key responsibilities include:
- Reviewing service requests to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts.
- Utilizing client-specific criteria sets, medical policy, and clinical guidelines for decision-making.
- Consulting with clinical reviewers and/or U.S. licensed medical directors to ensure medically appropriate, high-quality, cost-effective care.
The ideal candidate will have an active and non-active USRN license, at least 1 year of clinical or hospital experience, and a USRN with RN license.
This is a full-time position with a work setup of work from home.
We are in partnership with multiple companies for this position, offering you an option to choose the best fit.
Please note that this is a direct employment with no bond.
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Clinical Nurse Case Manager
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Delhi, Delhi, India Nezda Technologies Inc. Full timeAt Nezda Technologies Inc., we are seeking a highly skilled Clinical Nurse Case Manager to join our team.### Qualifications and Requirements* Active and Non-Active USRN License* At least 1 Year Clinical or Hospital Experience* USRN with RN License### Job DescriptionAs a Clinical Nurse Case Manager, you will be responsible for conducting medical management...
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