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)
Hiring a Staff Registered Nurse (RN) for a full time, 13 weeks contract position in Washington Court House, OH for a healthcare facility.
To do well in this role you should have your state Registered Nurse (RN) license and one year of ER working experience.
To apply submit a RESUME and a representative will contact you within one business day.
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0 Staff Nurse - RN, Sr. - Medical Management jobs found in Chillicothe, OH area