Staff Nurse - RN - Medical Management coordinates with care providers and plan members with the goal of maximizing member benefits while managing costs. Assesses medical necessity of procedures and/or admissions, conducts pre-certification or authorization, and monitors compliance with established guidelines. Being a Staff Nurse - RN - 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 - Medical Management typically requires a bachelor's degree in nursing. Typically reports to a manager. Requires a valid state RN license. To be a Staff Nurse - RN - Medical Management typically requires 3-5 years of related experience. Gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. (Copyright 2024 Salary.com)
*Weekly amount stated in the job postings is scaled based on estimated hourly wages and potential stipends available for the location of the assignment. Hourly wages are based on various factors including but not limited to: experience, demand, availability, location, etc. Please contact one of our amazing OneStaff Recruiting Specialists for more details.
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0 Staff Nurse - RN - Medical Management jobs found in Sumter, SC area