Staff Nurse - RN - Medical Management coordinates with care providers and plan members with the goal of maximizing member benefits while managing costs. Assesses medical necessity of procedures and/or admissions, conducts pre-certification or authorization, and monitors compliance with established guidelines. Being a Staff Nurse - RN - Medical Management assists members in appeals for denied services. Interprets benefits and guides members to choose to the appropriate providers, projects and resources. Additionally, Staff Nurse - RN - Medical Management typically requires a bachelor's degree in nursing. Typically reports to a manager. Requires a valid state RN license. To be a Staff Nurse - RN - Medical Management typically requires 3-5 years of related experience. Gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. (Copyright 2024 Salary.com)
Please double check you have the right level of experience and qualifications by reading the full overview of this opportunity below.
At CoreMedical Group, we will prep you for your interview, negotiate the best rate, assist in the state licensing process, provide local realty contacts, and do our best to ensure your interview/relocation experience is stress-free.
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0 Staff Nurse - RN - Medical Management jobs found in Beaumont, TX area