Medical Management Nurse

SH-900 Medical Management Nurse Remote in Indiana

Summary

Position Summary:

This role involves managing a case load with a focus on medical necessity reviews, clinical requests, and effective case management. If you have a keen eye for detail, excellent clinical judgment, and enjoy working in a dynamic, virtual environment, we’d love to hear from you.

Key Responsibilities

• Manage a census of 35-45 cases, aiming to address 25 cases per day. Responsibilities include medical necessity reviews, handling clinical requests, managing discharges, and making case management referrals.
• Participate in bi-weekly rounds with physicians and the case management team to coordinate patient care effectively.
  
  

Qualifications

• Candidate must have acute care, ICU, and Med/Surg experience in an inpatient hospital (bedside care) setting.
• Required experience in Utilization Management and/or familiarity with Milliman Care Guidelines.
• Required experience in acute inpatient (hospital) nursing, demonstrating strong clinical knowledge and decision-making skills.
• Comfortable working in a virtual setting with proficiency in IT/computer applications, including Excel, Microsoft Outlook, and Microsoft Teams.
• Quick learner with the ability to adapt to frequent process changes.
• Consistent and excellent attendance record.
• Valid Indiana RN license or compact license is essential.
  
  

Syra Health is an equal opportunity employer and values diversity at all levels. Lived experience and non-traditional backgrounds are welcomed and encouraged.