Staff Nurse - RN, Sr. - Medical Management leads the coordination between care providers and plan members with the goal of maximizing member benefits while managing costs. Oversees the assessment of medical necessity of procedures and/or admissions, conducts pre-certification or authorization, and ensures compliance with established guidelines. Being a Staff Nurse - RN, Sr. - 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, Sr. - Medical Management applies the medical and reimbursement policies within the claim adjudication process. Typically requires a bachelor's degree in Nursing. Typically reports to a manager. Requires RN license. To be a Staff Nurse - RN, Sr. - Medical Management typically requires more than 5 years of related experience. Contributes to moderately complex aspects of a project. Work is generally independent and collaborative in nature. (Copyright 2024 Salary.com)
Night
5 shifts x 8 hours
03/03/2024 8 wks
$2,049/wk
Contract DetailsJob Type Travel
Shift Type Night
Contract Date 03/03/2024 - 04/28/2024
Expected Length 8
Hours Per Week 8
Shifts Per Week 5
Facility Info Sign Up to View Facility
**Shift: 11:00 PM - 7:00 AM Experience: 12 months of role experience is required. 12 months of Nurse Management experience is required. Experience with PointClickCare is preferred. Requirements: Candidates must have a New York license in hand at the time of application. This role will require floating to multiple units COVID vaccination required for onboarding. Religious and medical declinations accepted. Pre-employment modules may be required for this role. Please upload any certifications or health documents you have to your profile to expedite your on-boarding process. Additional Details: Weekend Rotation. No on call. Holidays required. 2 references (Any reference type) Certifications: BLS (Basic Life Support)Clear All
0 Staff Nurse - RN, Sr. - Medical Management jobs found in Buffalo, NY area