Job Description:

As one of the world's top International Medical Insurance companies, IMG helps individuals and companies of all sizes. Every second of every day, vacationers, those working or living abroad for short or extended periods, people traveling frequently between countries, and those who maintain multiple countries of residence use our products to give themselves global peace of mind®We are looking to grow our teams with people who share our energy and enthusiasm for creating the best experience for travelers.JOB DETAILSRN License -- Must have an active RN license in good standing in Indiana.Location: Hybrid or Remote working options. Corporate office is in Indianapolis, IN.Relocation Expenses Reimbursed: NoQualified candidates must be legally authorized to be employed in the United States. IMG will not be providing sponsorship for employment visa status (e.g., H-1B or TN status) for this position.Job SummaryEvaluate medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities for utilization review and or evacuationrepatriation. Work as a liaison between the Insured, the insurance carrier and the Insured's healthcare team to meet the requirements of the Insured's policy in the United States and abroad.PERKSComprehensive benefits package including MedicalRXDentalVision insurance401k Plan with company matchPaid Time Off and Company Paid HolidaysFree employee parkingOn site fitness centerCasual dress environmentTuition reimbursement planDuties And ResponsibilitiesPerform Certifications, Concurrent Reviews, Retrospective Reviews, and Medical EvacuationsRepatriations including inpatient and outpatient management of assistance cases.Knowledge of the Non-certification process and Appeals process including logs and time frames.Participate in the on call rotation schedule.The provision of telephone and email based pre travel advice Direct andor re-direct members to in-network providers.Negotiate discounts with out of network providers.Direct healthcare team members to utilize alternative care settings when appropriate.Identify potential large case management cases by diagnosis, dollar amount andor high utilization of medical services and refer those identified for large case management.Document information and status in case management systems and documentPrepare precertification andor case management reports as needed.Use good judgment when evaluating medical cases and confer with Medical Director when municate with other members of team as needed, and ensure that information is shared appropriately.Maintain confidentiality and privacy of all protected health information.Continue education through relevant reading materials, online courses andor seminars.Support and participate in Quality Management activities.Utilize clinical support tools as indicated.Maintain a working knowledge of the any applicable state or federal regulations as appropriate for job duties.Reportdocument complaints whenif received.Any other job duties or tasks as assigned.QualificationsCurrent and active Nursing license - Registered Nurse Minimum two years acute hospital-based experience providing direct patient careGood computer skills including familiarity with the Internet, Word and Excel.Preferred SkillsB.S.N. PreferredMinimum two years utilization review with a managed care or insurance companyProficient verbal and written communication skills in a foreign language preferredExcellent computer skills, including database knowledge.Experience auditing medical charts against itemized medical billsPROFESSIONAL COMPETENCIESCommunication - Must be able to express ideas clearly, concisely, and logically. Must make effective and persuasive arguments when discussing medical care issues. Initiative - proactive in resolving problems, reporting discrepancies, suggesting new ideas and seeking process improvements.Judgment - use of good clinical judgment in resolving questions of medical necessity as it relates to precertifications and case management.Flexibility - must be willing to adjust as the industry or job requirements change.Teamwork - must work well in a team and help foster a cooperative environment.Represent a positive, professional image of the company.Excellent customer service skills and phone etiquette.Excellent organizational skills and attention to detail.WORK CONDITIONSOffice environment settingAble to work comfortably in a desk environment90+% of the time spent sitting, doing keyboard entry and utilizing a mouseIMG is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, ethnicity, national origin, religion, gender, gender identity or expression, sexual orientation, genetic information, disability, age, veteran status, and other protected statuses as required by applicable law.