Staff Nurse - RN - Medical Management jobs in Santa Ana, CA

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 2020


134 Staff Nurse - RN - Medical Management jobs found in Santa Ana, CA area

Travel Nurse RN - ICU - Intensive Care Unit - $1,973 per week
  • Advanced Travel Nursing
  • Downey, CA
  • ... Respond to medical emergencies and alert the appropriate doctors Manage medication doses ... staffing company for nurses. As one of the largest employment agencies in the United States, our ...
  • 6 hours ago

  • PIH Health
  • Westminster, CA
  • ... medical (physician) group, home healthcare services and hospice care, as well as heart, cancer ... Management Executives (CHIME) as one of the nation's top hospital systems for best practices ...
  • 2 days ago

+$48/hr Registered Nurse | Skilled Nursing | ASAP Start!
  • Ro Health- Los Angeles
  • Anaheim, CA
  • ... medical and/or psychiatric care and report changes in patient condition to the RN * Obtain ... Led by management with nearly 20 years of healthcare staffing experience, Ro Health is a ...
  • 2 days ago

Grievance and Appeals Nurse (LVN or RN)
  • MediQuest Staffing
  • Orange, CA
  • Managed Care, IPA, or Health Plan experience is preferred Referral Bonus: * Not interested? Know ... support staff. Our dedicated medical focus and expertise allow us to build collaborative ...
  • 3 days ago

Registered Nurse RN Hospice
  • Companion Health Group
  • Pomona, CA
  • WHAT YOU BRING TO COMPANION Your medical expertise to be the liaison between the medical team and ... We welcome your non-traditional ideas regarding comfort and symptom management for each individual ...
  • 4 days ago

Registered Nurse (RN) - Tele-Triage
  • Companion Health Group
  • Downey, CA
  • The Tele-Triage Nurse will be responsible for patient triage,assist with nurse case management ... Minimum of three years experience in direct patient care, preferably in hospice and/or medical ...
  • 5 days ago

Clinical Care Coordinator - Must be a Registered Nurse (RN)
  • Colonial Care Center
  • Long Beach, CA
  • ... staff o Bedside care as needed o Suctioning o Identify change of condition o Follow up on skin ... changes o IV management o Tracheostomy care/tracheostomy tube change o Dressing condition ...
  • 5 days ago

Registered Nurse RN Home Health
  • Tender Home Health
  • Westminster, CA
  • Case management of patient services includes: * Perform initial evaluation, follow up visit and ... Establish the patient's individualized treatment (Plan of Care) and medical record baseline
  • 6 days ago

Santa Ana /ˌsæntə ˈænə/ (Spanish for "Saint Anne") is the county seat and second most populous city in Orange County, California in the Los Angeles metropolitan area. The United States Census Bureau estimated its 2011 population at 329,427, making Santa Ana the 57th most-populous city in the United States. Santa Ana is in Southern California, adjacent to the Santa Ana River, about 10 miles (16 km) from the coast. Founded in 1869, the city is part of the Greater Los Angeles Area, the second largest metropolitan area in the United States, with almost 18 million residents in 2010. Santa Ana is a ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Staff Nurse - RN - Medical Management jobs
$82,838 to $96,885
Santa Ana, California area prices
were up 2.5% from a year ago