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)
Our client is seeking a Registered Nurse to work in a primary care setting, providing care for patients of all ages. The role involves conducting sick visits, physicals, and lab draws, with a focus on pediatric care. The nurse will work closely with providers in a collaborative environment.
Key Responsibilities
● Provide care for patients of all ages
● Perform sick visits and physicals
● Conduct lab draws
● Work closely with providers
Schedule and Shift Details
● Monday: 7a-530p (60 min lunch) Tuesday: 7a-11a (labs) Wednesday: 7a-1p Thursday: 7a-530p (60 min lunch) Friday: 8a-12p
This is a primary care setting, ages 2 . Sick visits, physicals, lab draws, 2-3 patients per hour, one nurse and one provider on shift.
Travel
● No travel required
Job Type: Full-time
Benefits:
Medical specialties:
Standard shift:
Weekly schedule:
Ability to Relocate:
Work Location: In person
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0 Staff Nurse - RN, Sr. - Medical Management jobs found in Gastonia, NC area