Medical Management Nurse

SH-900 Medical Management Nurse Remote in Indiana 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. #J-18808-Ljbffr