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)
Glenn Medical Center is a Critical Access Hospital located in Willows CA, in partnership with our physicians, will consistently strive to provide accessible, high quality care within the local community. Our focus is on improving the health and well-being of all individuals by offering inpatient, outpatient and rural health clinic services to the Glenn County community.
FULL & PART TIME
DAY SHIFT POSITIONS AVAILABLE
Job Summary
The staff RN is a professional care giver who assumes responsibility and accountability for a group of patients for a designated time frame and provides care to these patients via therapeutic use of self, the nursing process, the therapeutic environment, treatment and modalities and interdisciplinary collaboration.
Qualifications
Graduation from school of nursing. Current state licensure. Current BLS. Physical/emotional stamina. Communication/writing skills. Recent experience in a clinical. Effective interpersonal skills. Meets specific departmental criteria and/or certifications.
Licensure/Certifications:
Duties and Responsibilities
Corporate Compliance:
Conduct hospital business in an ethical and lawful manner and is willing to report any knowledge of real or potential fraud or abuse according to the CMC Code of Conduct.
0 Staff Nurse - RN, Sr. - Medical Management jobs found in Chico, CA area