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)
Minden Medical Center is looking for well-organized, energetic, RN/ Case Management
The ideal candidates will have the ability to interact in a positive and compassionate manner with patients, co-workers, physician's and supervisors.
Here at MMC, we strive to provide excellent care to the patients we serve and to create a work environment that supports and encourages you to learn, grow and reach your highest potential. At MMC we believe our employees are our most valuable assets.
MMC offers competitive salaries and complete benefit packages
Minimum Education & Experience: Current RN licensure with the Louisiana State Board of Nursing required; 2 years hospital experience preferred.
Required Certification/Registration CPR required; ACLS & PALS required within in 6 months