BMC Company LLC

Case Manager (on site), Denials and Appeals, 30 Hours (Weekends)

BMC Company LLC(1 month ago)

Boston, MAOnsitePart TimeMedior$76,100 - $150,660Denials and Appeals
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About this role

A Utilization Management/Case Management Registered Nurse responsible for supporting utilization review and care management activities for tertiary care transfers within the hospital system. The role interfaces with multidisciplinary teams and payers to ensure compliance with utilization review standards and organizational policies. It is based onsite in the Denials and Appeals department and covers a weekend-focused 30-hour schedule.

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Required Skills

  • Utilization Management
  • Case Management
  • Care Coordination
  • Clinical Assessment
  • Medical Coding
  • Managed Care
  • Data Management
  • Communication
  • Negotiation
  • Analytical Skills

Qualifications

  • BS in Nursing
  • Registered Nurse License (Massachusetts)
  • CCM (Preferred within 24 months)

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