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 2025 Salary.com)

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Advanced Specialty Staff RN - Medical Forensic Nurse
  • Providence RN
  • Portland, OR FULL_TIME
  • Description

    The forensic nurse examiner will provide timely, compassionate care to patients seeking medical-forensic exams in accordance with established protocols. This will include completing a medical-forensic exam, providing prophylaxis for pregnancy and sexually transmitted infections, photographic documentation, and completing referrals for appropriate medical and psychological follow-up. The FNE will also collaborate with community partners including advocacy agencies, law enforcement, prosecutors, and child and vulnerable adult protection agencies where applicable.

    Providence caregivers are not simply valued – they’re invaluable. Join our team at Oregon Clinical Programs and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.

    Required qualifications :

    • Graduation from an accredited nursing program.
    • Upon hire : Oregon Registered Nurse License
    • Upon hire : National Provider BLS - American Heart Association
    • 1 year of Nursing experience.

    Why Join Providence?

    Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.

    About Providence

    At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

    The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby / on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

    Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs / benefits.

    About the Team

    Providence Clinical Network (PCN) is a service line within Providence serving patients across seven states with quality, compassionate, coordinated care. Collectively, our medical groups and affiliate practices are the third largest group in the country with over 11,000 providers, 900 clinics and 30,000 caregivers.

    PCN is comprised of Providence Medical Group in Alaska, Washington, Montana and Oregon; Swedish Medical Group in Washington’s greater Puget Sound area, Pacific Medical Centers in western Washington; Kadlec in southeast Washington; Providence’s St. John’s Medical Foundation in Southern California; Providence Medical Institute in Southern California; Providence Facey Medical Foundation in Southern California; Providence Medical Foundation in Northern and Southern California; and Covenant Medical Group and Covenant Health Partners in west Texas and eastern New Mexico.

    Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.

    Requsition ID : 337717

    Company : Providence Jobs

    Job Category : Nursing-Patient Facing

    Job Function : Nursing

    Job Schedule : Part time

    Job Shift : Night

    Career Track : Nursing

    Department : 5013 MEDICAL FORENSIC NURSE

    Address : OR Portland 4400 NE Halsey St

    Work Location : Providence Office Park Portland Bldg 1-Portland

    Workplace Type : On-site

    Pay Range : $42.67 - $67.54

    The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby / on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

    PandoLogic. Category : , Keywords : Forensic Nurse

  • 3 Days Ago

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AZ - RN Case Management/Utilization Review
  • RN Staff
  • Yuma, AZ FULL_TIME
  • *******Fingerprinting must be submitted and cleared prior to start!***** **PLEASE SUBMIT CURRENT ADDRESS FOR FINGERPRINT PACKET TO BE MAILED VIA FEDERAL EXPRES** Please submit only if Tuba City housin...
  • 14 Days Ago

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Medical Laboratory Tech/Technologist
  • RN-Staff
  • Iowa, IA FULL_TIME
  • Position SummaryThe Laboratory Technician / Technologist works to provide accurate, timely, and cost effective testing of patient samples to aid in the diagnosis and treatment of disease. The position...
  • Just Posted

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Weekend Option - Staff Nurse - Medical Surgical Float RN (CRU 4) Days
  • Staff Nurse - Medical Surgical Float RN (CRU 4) Days - Jobs@UIOWA Careers
  • Iowa, IA FULL_TIME
  • Qualified candidates with a minimum of two years of experience are eligible for a sign-on bonus up to $12,500 The University of Iowa Hospitals and Clinics Department of Nursing is seeking a Clinical R...
  • 2 Months Ago

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Cardiac Cath Lab Nurse - Days with Call
  • RN-Staff
  • Opheim, MT FULL_TIME
  • 2 room growing Cath / IR Lab performing approx 5 cases per day using Philips Xray / Xper Hemo equipment and Meditech EMR. Procedures include Left and Right Heart Cath / PCI, PM / ICD, Structural Heart...
  • 2 Days Ago

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MA - Gardner, MA - Registered Nurse, Emergency Department
  • RN-Staff
  • Boston, MA FULL_TIME
  • Qualifications :Minimum AS in nursing required.BS in nursing preferred.Current RN MA License required.AHA BLS required.ACLS obtained within 60-days of hire.AHA PALS required within six (6) months of h...
  • 4 Days Ago

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Staff Nurse
  • Nip & Tuck Plastic Surgery LLC
  • Atlanta, GA
  • Job Description Job Description Job Summary: Plastic surgery practice is seeking a Licensed Nurse (LPN or RN) who is wel...
  • 1/18/2025 12:00:00 AM

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RN Staff Nurse
  • GOLDEN AGE CARE LLC
  • Morganville, NJ
  • Job Description Job Description We are seeking an RN Staff Nurse (part time ) to join our team! Responsibilities: Daily ...
  • 1/18/2025 12:00:00 AM

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CLINICAL STAFF NURSE
  • Vibrant Health KC
  • Kansas City, KS
  • Job Description Job Description SUMMARY OF POSITION The Clinical Staff Nurse is an integral part of the health care team...
  • 1/16/2025 12:00:00 AM

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Staff Nurse-LPN
  • Broward Community & Family Health Centers, Inc.
  • Pompano Beach, FL
  • Job Description Job Description We are seeking a Staff Nurse to join our team at our Pompano, Lauderhill and West Park l...
  • 1/16/2025 12:00:00 AM

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LPN Staff Nurse
  • Biomed Behavioral Healthcare Services, PC
  • Flint, MI
  • Job Description Job Description Job Description: LPNs only! Assess patients and dispense accurate medication amounts. Ma...
  • 1/15/2025 12:00:00 AM

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Staff Nurse
  • HopeHealth Inc
  • Aiken, SC
  • Job Description Job Description Overview of the Position: The Staff Nurse is an essential member of the patient center m...
  • 1/14/2025 12:00:00 AM

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RN Staff Nurse
  • ServeFed
  • Andover, MA
  • Job Description Job Description Job Specific Details and Tasks: The duties include, but are not limited to the following...
  • 1/14/2025 12:00:00 AM

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Staff Nurse RN
  • SISTERS OF THE HOLY CROSS INC
  • Mishawaka, IN
  • Job Description Job Description Vision for Person Directed Living Person Directed Living (PDL) shapes and informs the wa...
  • 1/14/2025 12:00:00 AM

Income Estimation for Staff Nurse - RN, Sr. - Medical Management jobs
$91,985 to $114,933