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)
Preferred Care At Absecon is currently looking for experienced Nurses to join our team of healthcare professionals.
**SIGN UP BONUS!! $5,000**
Salary $62,000 - $75,000
Preferred Care At Absecon is Located In Absecon, NJ
We have Full Time, Part Time and Per Diem Nurse positions available
7am-3PM 3pm-11pm & 11pm-7am shifts
Professional Development for Staff Nurse
We understand that you want to succeed not only as a person but also as a professional.
At Preferred Care At Absecon, we believe in providing our associates with growth opportunities through career advancement to help you reach your maximum potential.
Benefits for Qualified Associates Our competitive benefits package for Staff Nurse
Health Insurance
Dental Insurance
Continuous professional and clinical training
Competitive Pay and a nice benefit package
Experience required
Job Type: Full-time
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0 Staff Nurse - RN, Sr. - Medical Management jobs found in Vineland, NJ area