RN, Managed Care Specialist

Nurse


BlueCross BlueShield of Arizona, one of the state's largest local and non-profit health insurers, strives to provide our customers and employees with resources to help them improve their health status. For over 60 years we've been providing health insurance to Arizonans.




RN, Managed Care Specialist


We'll count on you to handle precertification and contract benefits, utilizing case management criteria and guidelines for comprehensive or catastrophic cases. You'll adjudicate claims, research related medical review edits and review reconsiderations. Includes analyzing and monitoring claims and appeals for areas needing updating or enhancement, participating on task forces, reporting statistics, misc. administrative duties and more. Qualifications: RN with current AZ license, 3 yrs clinical nursing exp, and managed care exp. (Desired qualifications: Utilization review, quality assurance, or health insurance exp; utilization review or case mgmnt certification; health-related BS or higher.)

Join BCBSAZ, one of the Phoenix Business Journal's Best Places to Work in the Valley for 2005. You'll enjoy an attractive benefits package plus a dynamic, growth-oriented work environment. Email resumes to:
[Click here for email]. (when attaching a resume in Word, please use the following format: last name.first name.resume.doc. (example: smith.john.resume.doc) FAX (602) 864-5685. Job Hotline (602) 864-4339. We support a drug-free work environment through pre-employment drug testing. Equal Opportunity Employer. No Agency calls please.

Source - Arizona Republic - Phoenix, AZ
REQUIREMENTS
Please refer to the Job Description to view the requirements for this job