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)
RN (Registered Nurses)! Shifts Available 7am-5pm & 9pm-7am
Are you tired of running from the moment you arrive at work until the end of your shift?
Home Staff Inc is one of the leading private duty nursing companies in Illinois with clients spread throughout Illinois. Consider working as a Private Duty Nurse and provide one on one care with one client who will really appreciate your services!
No pediatric or private duty nursing experience required!
Full-time, Part-time and Supplemental shifts available immediately!
Registered Nurse Responsibilities:
Home Staff Benefits:
Interested in learning more? Apply Now!
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0 Staff Nurse - RN - Medical Management jobs found in Racine, WI area