USRN Case Manager Nurse (Hybrid Set-up)

Additionally, they will often communicate with nursing staff, billing teams, medical social workers, and personnel from various departments.

• Performs case management including obtaining prior authorization for drugs and procedures according to hospital policy and procedures.
• Promotes, coordinates, and takes responsibility for completion of all activities associated with case management.
• Ensure that all patient information is handled in accordance with HIPAA regulations.
• Ability to perform tasks in line with authorizations for outpatient services, denial letters, and similar activities.

Qualifications:

• Graduate of BS Nursing, USRN required.
• At least 2 years previous hospital nursing experience or Case Management experience in a clinical setting for a US-based healthcare company, required.
• Excellent verbal and written communication skills
• Experience with Prior Authorization / Case Management / Utilization Review
• Proficient computer and software skills

ADDITIONAL REQUIREMENT:

• Strong nurse with experience in acute oncology care , case management , utilization review
• Prior authorization experience
• Willing to work in Ortigas in an onsite work arrangement.
• Amenable to work in a graveyard shift schedule.
• Must be a USRN/NY Licenses