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)
Lompoc Valley Medical Center - Registered Nurse (RN) - Skilled Nursing Facility/Long Term Care (SNF/LTC) in our Comprehensive Care Center (CCC)
About our Comprehensive Care Center:
Our CCC is 110 bed capacity and we provide a higher level of supervision and care when people need more help with their day-to-day activities. We are also committed to making transitions as easy as possible for skilled nursing and post-acute rehabilitation residents. Our rehabilitative treatments are tailored specifically to meet each resident’s goal of increased independence.
Position Overview:
We are seeking a dedicated and compassionate Registered Nurse (RN) to join our Long-Term Care team. The ideal candidate will provide comprehensive nursing care to residents in our facility, promoting their health and well-being.
Responsibilities:
Qualifications:
Benefits:
arodgers@prolinstaff.com
#RPO
Job Type: Full-time
Pay: $45.48 - $62.70 per hour
Benefits:
Standard shift:
Supplemental pay types:
Ability to Relocate:
Work Location: In person
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0 Staff Nurse - RN, Sr. - Medical Management jobs found in Lompoc, CA area