Remote Population Health Nurse

Summary

Intus Care is seeking a dynamic Population Health Nurse with Utilization Management experience to support the Interdisciplinary Team, work with PACE Program customers, and manage various aspects of the utilization management process. The role involves assuring adherence to PACE program service authorization policies, coordinating claim disputes, designing population-based care coordination activities, and identifying high-risk participants. The position requires 3 to 5 years of utilization management experience, a current RN license, and strong critical thinking skills.

Requirements

• 3 to 5 years of utilization management experience
• Current RN license

Responsibilities

• Assure rigorous adherence to PACE program service authorization policies
• Actively participate in and/or manage various aspects of the utilization management process
• Coordinate Claim Disputes - In cases of claim rejection, lead the provider dispute process
• Design, implementation and management of population-based care coordination activities

Benefits

• Competitive salary package
• Comprehensive benefits including health, dental, and vision insurance
• A collaborative, inclusive, and dynamic work environment
• Opportunities for professional growth and development