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 2020

Travel Nurse RN - Med Surg / Telemetry - $1,789 per week
  • NurseFly Travel Nursing
  • Gig Harbor, WA
  • Our managers and executive staff hold daily "Stand-Up" meetings where we not only discuss the needs ... rn, med surg / telemetry nurse.
  • yesterday

RN Residential Care Facility (RCF)
  • Rivera Mansions LLC
  • Portland, OR
  • ... our senior population. Interested candidates should preferably have 1+ years experience in ... Assists with staff training and orientation as needed and per facility policies * RN delegates ...
  • yesterday

Travel Registered Nurse RN Intensive Care unit ICU
  • One Staff Medical
  • Livingston, NJ
  • Intensive care unit (ICU) staff RNs provide care for patients with life-threatening medical conditions. These nurses work in the critical care unit of a hospital or healthcare facility and look after ...
  • yesterday

RN Med/Surg
  • Alto Health Care Staffing
  • Beaufort, SC
  • SCZip: 29902Job Id: 12058698 Website AltoStaffing Alto StaffingYour position is our missionAlto Health Care Staffing has a travel contract available for a qualified Med/Surg RN in Beaufort SC
  • 2 days ago

Travel Registered Nurse RN Cath Lab
  • One Staff Medical
  • Gig Harbor, WA
  • OneStaff Medical has an assignment available for a Travel Registered Nurse RN Cath LabJoin the OneStaff Medical Team of Healthcare professionals as a Travel Registered Nurse RN Cath LabJob ...
  • 2 days ago

RN Supervisor Urgent Care
  • Nexus Healthcare
  • Glendale, CA
  • Ensures appropriate staffing levels by scheduling on a daily and monthly basis within budgetary ... Participates in educational programs to enhance nursing and management knowledge.Uses, protects ...
  • 2 days ago

Travel Operating Room RN Job Yakima WA
  • Soliant
  • Yakima, WA
  • Sonja Starks Senior Account Executive Soliant Health | (770) 325-0563 | Fax: 866-386-9426 | Sonja ... staff for all RN disciplines including: ER, OR, CVOR, OR Tech, CVOR Tech, ICU, Med Surg, CVICU ...
  • 4 days ago

Registered Nurse (RN) - Home Health & Hospice
  • Continuum Medical Staffing
  • South Lake Tahoe, CA
  • Home Health & Hospice RN needed for long term contract assignment in South Lake Tahoe, CA. Housing ... Medical Staffing employs and places healthcare professionals such as Senior Leader Management ...
  • 6 days ago

Income Estimation for Staff Nurse - RN, Sr. - Medical Management jobs
$80,746 to $100,893