Case Manager/Medical Review Nurse 

DWBHCORP is seeking RN Case Managers/Medical Review Nurses to support the detection and prevention of potential Medicare Part C and Part D fraud, waste, and abuse. BSN with current and active degree/license/certification/s in a relevant healthcare discipline (i.e., CPC, CPHM, CFE, CCM, HCAFA). Must possess at least 4 years clinical experience. At least one year healthcare experience that demonstrates expertise in conducting utilization reviews, ICD-9 coding, CPT coding, and specifically strong Medicare Part C and D experience and knowledge preferred. Prior successful experience with CMS, State Medicaid, and OIG/FBI or similar agencies also preferred. This position will serve as a subject matter expert in assisting auditors, data analysts, investigators, and other designated staff conducting data and investigative analysis. If interested in hearing more about this position, including the additional qualification requirements, please send an inquiry to: [email protected]