Registered Nurse - Health Plan Operations

VirtualVocations
Norcross, Georgia, United States
Full-time

A company is looking for a Nurse Specialist in Health Plan Operations.Key ResponsibilitiesCollaborate between clinical and operations teams to guide member care and apply benefitsAssess treatment plans and develop standard operating procedures (SOPs) based on evidence-based practicesMonitor benefits coverage and identify cost containment opportunitiesRequired QualificationsBachelor's degree in nursingActive RN or NP license in the state hired5+ years of nursing experience3+ years of experience with utilization management and medical record reviewsExperience with health plan operations, preferably with a third-party administrator or health plan

17 days ago
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