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)
Looking for a Staff RN to join a team in eastern NV. This non-profit entity is north of Las Vegas and provides services appropriate to their service area and coordinates access to needed health services.
They recently expanded their service area to include the residents of Eureka County as well. Their mission is to provide quality health services in a compassionate, safe and secure environment that supports the dignity of individuals and families.
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0 Staff Nurse - RN - Medical Management jobs found in Las Vegas, NV area