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)
Welcome to RNstaff, where compassion connects careers. We're not just a recruiting company; we're people who care about people. Join us in shaping the future of healthcare together.
__________________________________________RNStaff is looking for USRNs looking for a permanent contract in the State of Maryland. International RNs looking for sponsorship program are very welcome.
See Job Description:
Responsibilities:
Certifications -
AHA ACLS - Advanced Cardiac Life Support Certificate
AHA PALS - Pediatric Advanced Life Support Certificate
Education - Required
Experience - Required
Licenses - Required
Referral Bonus from $250 up to $2000!!
Submission Requirements Reminders(Disregard if completed)
https://rnstaff.com/skills-checklists/
Log in your online portal and Apply Now!
Ann Dizon
Account Manager
317 328 2866
ann@rnstaff.com
7345 Woodland Dr, Indianapolis, IN 46278
Clear All
0 Staff Nurse - RN, Sr. - Medical Management jobs found in Virginia Beach, VA area