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 2021 Salary.com)

A
RN Supervisor
  • All Medical Personnel
  • Santa Rosa, CA
  • Serves as the point-of-contact for other interdisciplinary staff for coordination of nursing ... Senior Account Manager ‚ÄčAll Medical Personnel | Nursing Main: 800-410-0084 Email
  • yesterday

F
Wellness Nurse RN
  • Farmington Square Eugene
  • Eugene, OR
  • ... Management Company. The Wellness Nurse - RN is delegated the administrative authority ... ABOUT RADIANT SENIOR LIVING VISION We will be recognized as an innovative provider of quality ...
  • 2 days ago

S
Registered Nurse Case Manager/RN - Full-Time Home Health
  • Signature Hospice
  • Bellingham, WA
  • Our professional clinical staff work in a collaborative environment and have weekly team meetings ... Caleb Brunton Sr. Talent Acquisition Specialist Signature Healthcare at Home C: 385-277-0524 E ...
  • 3 days ago

K
Director of Nursing ( DON - RN ) - $5000 Bonus - Delaware Plaza
  • Koelsch Communities
  • Longview, WA
  • Our amazing nurses on staff right now consist of new graduates that are enthusiastic and excited ... senior living, health and wellness director, nurse manager, clinical director, clinical nurse ...
  • 3 days ago

A
RN Care Management
  • All Medical Personnel
  • San Francisco, CA
  • ... Us All Medical Personnel is a national leader in healthcare staffing recognized by Staffing ... Senior Account Manager All Medical Personnel | Nursing Main: 800-410-0084 Email
  • 3 days ago

P
RN - Recovery
  • Providence St. Joseph's Health
  • Lake County, CA
  • ... Medical Center in Tarzana, CA. We are seeking a Registered Nurse (RN) in Recovery who will provide ... Skilled to work with a wide range of staff as part of an interdisciplinary team including ...
  • 3 days ago

M
Nurse - RN / LPN
  • Miller's Health Systems
  • Wakarusa, IN
  • As operators of more than 40 nursing care and senior living properties across the state, MHS offers ... You follow the Comprehensive Care Plan for your patients and assist the Unit Manager with thorough ...
  • 3 days ago

K
Licensed Nurse ( LPN / RN ) $3000 Bonus - Canterbury Inn
  • Koelsch Communities
  • Longview, WA
  • Our amazing nurses on staff right now consist of new graduates that are enthusiastic and excited ... Koelsch has led the Senior Living industry for over 60 years, delivering world-class customer ...
  • 4 days ago

Income Estimation for Staff Nurse - RN, Sr. - Medical Management jobs
$82,779 to $103,433