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)
We are looking for a Registered Nurse to care for our patients and facilitate their speedy recovery. You will be responsible for educating them and their families on prevention and healthy habits. The ideal candidate will be a responsible and well-trained professional able to give the best nursing care with little supervision. You will be compassionate and cool-tempered. You will be able to follow health and safety guidelines faithfully and consistently. The goal is to promote patient’s well-being by providing high quality nursing care.
Responsibilities
Skills
Job Type: Full-time
Pay: $75,759.00 - $143,846.00 per year
Benefits:
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Standard shift:
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Work Location: In person
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0 Staff Nurse - RN, Sr. - Medical Management jobs found in La Crosse, WI area