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

Medical ICU (MICU) Travel Nurse RN - $78/hour
  • Nomad Health
  • Sarasota, FL
  • Active Registered Nurse license in the specified state. RN degree from an accredited registered ... Medical/Dental: Major medical and dental plans available from your first day of work.Payroll
  • just now

Travel Rehab RN
  • Titan Medical
  • Oklahoma City, OK
  • * Speciality: Rehab RN * Start Date: 8/31/2020 * Shift: Night * Length: 13 weeks Health care ... Titan Medical is one of the top medical staffing agencies because we provide superior support to ...
  • 1 hour ago

Staff RN - 12 Hr Med/Surg
  • Prime Healthcare
  • Torrance, CA
  • ... of care within the Medical/Surgical Unit. The Registered Nurse is directly responsible and ... Ventilator Management experience preferred. * Bachelor of Science in Nursing (BSN) preferred. We ...
  • 12 hours ago

Travel Nurse RN - Case Management - $2,208 per week
  • NurseFly Travel Nursing
  • Normal, IL
  • Skyline Med Staff Nursing is seeking a travel nurse RN Case Management for a travel nursing job in Normal, Illinois. Job Description & Requirements * Specialty: Case Management * Discipline: RN * ...
  • 2 days ago

RN or LPN - Covid 19 Testing - Contract/Travel
  • Continuum Medical Staffing
  • Kotzebue, AK
  • RN or LPN needed for 15 week assignment starting 8/24 (LPN) and 9/14 (RN). Will work 8 hour shifts ... Medical Staffing employs and places healthcare professionals such as Senior Leader Management ...
  • 3 days ago

RN Med/Surg Post Operative Unit Nights - Ortho
  • Hillcrest Hospital South
  • Tulsa, OK
  • The RN will collaborate with case management and physicians in the continuum of care. * The RN will ... and facilitates staff development. * Desirable characteristics include at least one year of ...
  • 5 days ago

Registered Nurse - RN (Float Pool Nurse)
  • Chesapeake Medical Staffing
  • Glen Burnie, MD
  • Chesapeake Medical Staffing RN Float Pool Nurse Chesapeake Medical Staffing (CMS) is currently seeking a RN - Float Pool Nurse for agency contract positions in Baltimore, MD Details: RN-Float Pool ...
  • 5 days ago

Travel Registered Nurse RN Case Management - Anaheim
  • OneStaff Medical
  • Oakland, CA
  • Case Management Nurses coordinate long-term care for their patients. Their goal is to treat their patients at optimal times to keep them healthy and out of the hospital. As a Case Management Nurse ...
  • 5 days ago

Income Estimation for Staff Nurse - RN, Sr. - Medical Management jobs
$81,203 to $101,462