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 Home Health LVN in Santa Maria, CA
13 week
Days /8 hours shift
Must have CA license , Covid Vaccination and HOme health Experience .
Pay package for 40 hours -$2150
Taxable- $1200
Non Taxable- $950
OT Rate- $75
LOCAL ACCEPTED
If you are interested and all the details work for you, please email your updated resume, and BLS on kimmi@Rnstaff.com , for quick response text me on (346 )-358-7203
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0 Staff Nurse - RN, Sr. - Medical Management jobs found in Santa Maria, CA area