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 Staff Healthcare LLC is seeking a Registered Nurse (RN) to join our dynamic team of professionals at Peninsula Rehabilitation and Nursing Center a skilled nursing facility!
**Shifts Available**
Qualifications of a Registered Nurse (RN):
**Rates with and without benefits are available!**
What we offer: We offer our staff with far more than just a place to work!! Rather, we are a company you can be proud of, where you’ll feel good about devoting your time and your talents.
Responsibilities of a Registered Nurse (RN):
We are an EOE
IND1
Job Types: Full-time, Part-time
Pay: $48.00 - $50.00 per hour
Benefits:
Medical specialties:
Physical setting:
Standard shift:
Supplemental schedule:
Weekly schedule:
License/Certification:
Work Location: In person
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0 Staff Nurse - RN, Sr. - Medical Management jobs found in Queens Village, NY area