Risico Total Managed Care , Inc. (Risico) is seeking a qualified Medical Management Nurse to join the Risico Team in our Fresno office. We are very excited about

…Record (EMRs) or Health Information Management (HIMs) systems reporting. Medicare knowledge & Managed Care Experience Value Based Care & Population Health

…contract rates and terms, case management process and procedures, and IDT role in the managed care process. The Wound Care Nurse Specialist WOCN will monitor

…mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and company policies and procedures, and

…or equivalent and 2+ years relevant work experience in the healthcare field required; managed care experience preferred. Must have a valid driver license, clean

…unrestricted CA clinical license. Knowledge, Skills & Abilities: Knowledge of managed care and state specific expertise preferred.Demonstrated experience

…Preferred Other Job Requirements Responsibilities * 3+ years of experience in managed clinical care , formal training design and/or facilitation and coaching

… care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral

…require a CME accreditation in specific specialties Prior case and/or utilization management/ care coordination and managed care experience preferred

…multi-task and work under pressure. Knowledge of general medical terminology and managed care functions highly preferred Working knowledge of electronic health