Staff Nurse - RN, Sr. - Medical Management jobs in the United States

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 2022 Salary.com)

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Quality Senior Manager RN
  • WellMed Medical Management
  • San Antonio, TX
  • OR staff and strategic initiatives to ensure the delivery of STARs/HEDIS data collection programs ... This role is a critical to achieve a higher level management skill set to ensure that WellMed ...
  • 2 days ago

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Senior Registered Nurse (RN) - Med Surg - Med Surg
  • University of Maryland Medical Center
  • Baltimore, MD
  • Our mission is partner with adults and children to achieve their best health by helping to manage ... When you join or team, you'll become a part of a close-knit group of more than 1,400 staff members ...
  • 2 days ago

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Travel Nurse RN - Case Management - $2,522 per week
  • Tact Medical Staffing
  • Dallas, OR
  • Tact Medical Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Dallas, Oregon. Job Description & Requirements * Specialty: Case Management * Discipline: RN * Start ...
  • 2 days ago

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Travel Nurse RN - Case Management - $2,274 per week
  • Synergy Medical Staffing
  • Wailuku, HI
  • Synergy Medical Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Wailuku, Hawaii. Job Description & Requirements * Specialty: Case Management * Discipline: RN * Start ...
  • 2 days ago

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Travel Nurse RN - Case Management - $3,039 per week, Days
  • 3D Medical Staffing
  • Dallas, OR
  • 3D Medical Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Dallas, Oregon. Job Description & Requirements * Specialty: Case Management * Discipline: RN * Start Date ...
  • 2 days ago

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Travel Nurse RN - Case Management - $3,668 per week
  • Skyline Med Staff Nursing
  • San Francisco, CA
  • Skyline Med Staff Nursing is seeking a travel nurse RN Case Management for a travel nursing job in San Francisco, California. Job Description & Requirements * Specialty: Case Management * Discipline ...
  • 3 days ago

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Unit Manager - RN
  • ManorCare Health Services
  • DuPont, WA
  • Now offering a $10,000 Sign on Bonus ProMedica Senior Care, formerly HCR ManorCare, provides a ... And yet your patients and staff recognize it in your patience, confidence, skill and compassion
  • 5 days ago

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Neuro Seasonal Registered Nurse
  • St. David's Medical Center
  • Austin, TX
  • ... PhD, RN CENP, FAAN Senior Vice President and Chief Nursing Executive Senior Vice President and ... case management or transfer centers. Unlock your potential at St. David's Medical Center! As a ...
  • 6 days ago

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RN Staff Nurse
  • HEALTHCARE RN
  • Middle Island, NY FULL_TIME
  • Hiring Licensed Registered Nurses (RNs) for Long Term Care Facilities. Immediate Hire!! Supervisor Positions Also Availa...
  • 28 Days Ago

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Regional Nurse Consultant-RN
  • FAST NURSE Staff
  • Eugene, OR FULL_TIME
  • Position Summary: Fast Nurse Staff is a company that provides on-demand executive level staff for senior housing operato...
  • 20 Days Ago

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RN Staff Nurse
  • HEALTHCARE RN
  • Middle Island, NY FULL_TIME
  • Hiring Licensed Registered Nurses (RNs) for Long Term Care Facilities.Immediate Hire!!Supervisor Positions Also Availabl...
  • 28 Days Ago

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Regional Nurse Consultant-RN
  • FAST NURSE Staff
  • Eugene, OR FULL_TIME
  • Position Summary: Fast Nurse Staff is a company that provides on-demand executive level staff for senior housing operato...
  • 20 Days Ago

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Staff Nurse RN Medical Surgical
  • Clinical Management Consultants
  • Corvallis, OR FULL_TIME
  • A Central Oregon Area Medical Center is actively seeking a Medical Surgical Staff Nurse to join their renown healthcare ...
  • 4 Days Ago

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RN Medical Surgical Staff Nurse
  • Clinical Management Consultants
  • Albany, OR FULL_TIME
  • A Central Oregon Area Medical Center is actively seeking a Medical Surgical Staff Nurse to join their renown healthcare ...
  • 4 Days Ago

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Medical Surgical Staff Nurse RN
  • Clinical Management Consultants
  • Cobleskill, NY FULL_TIME
  • A developing hospital in scenic upstate New York now seeks a professional Medical Surgical Staff Nurse RN to help contin...
  • 14 Days Ago

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Medical Surgical Staff Nurse RN
  • Clinical Management Consultants
  • Allegany, OR FULL_TIME
  • A reputable non profit Medical Center that is committed to providing high quality healthcare in beautiful, serene and co...
  • 15 Days Ago

Income Estimation for Staff Nurse - RN, Sr. - Medical Management jobs
$85,860 to $107,284