RN Managed Care Specialist to $69k+ -

Job Description: National medical insurance company seeking a RN managed care specialist. Duties include: Responsible for Claims Adjudication, Reconsideration and Retrospective Reviews, Precertification, and Claims Pricings. Candidate will possess the ability to apply department guidelines, contract benefits, and medical necessity guidelines. Will assist with administrative functions as required including but not limited to URAC standards and any and all applicable federal and state law. REQUIREMENTS: Registered nurse with a current, valid Arizona license; three years clinical nursing experience; prior experience in managed care, utilization review, quality assurance, or health insurance industry is desirable. Current certification in utilization review or case management is helpful. A bachelors or higher degree in a health-related field is desirable. Please email resumes to PJ You can view all of our jobs online at