Staff Nurse - RN, Sr. - Medical Management jobs in Delaware
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 2024 Salary.com)
Recently Added Staff Nurse - RN, Sr. - Medical Management jobs
- Medical Facilities of America
-
Wilmington, DE
FULL_TIME
-
Ask about our Daily Pay And our 15K Sign on Bonus !!!
Join our team at PIKE CREEK Nursing and Rehabilitation Center. As a member of our proud and caring team we care for our staff while we care for our residents and patients. As a member of Pike Creek Nursing and Rehabilitation Center, you will enjoy being part of a valued team where personal advancement and the development of skills are respected and where you will feel appreciated.
Join a company that admires, cares, appreciates, and values their employees!
We offer many exciting benefits:
- Competitive wages
- Comprehensive Benefits Package
- Advancement Opportunities
- Full Time
RN Facility Educator Responsibilities:
- Responsibilities include educational programs, provide training to nurses and skilled nursing staff, infection control education, assisting with care plans, and ensuring all aspects of compliance are being followed.
RN Facility Educator Requirements:
- Must possess valid unencumbered, RN State License. Nursing degree from an accredited college or university preferred.
- Minimum five (5) years of clinical nursing experience within a nursing care center or other related healthcare settings.
- Must have experience in supervision and principles, practice of teaching, etc.
- Superior communication and presentation skills.
- 19 Days Ago
- Peninsula Regional Medical Center
-
Seaford, DE
FULL_TIME
- Seaford, DETidalHealth NanticokeSurgical ServicesStandby(Work as needed) - Varied Weekdays, Rotating Weekends & Call - N/AReq #: 27496 Why work at TidalHealth?Looking for a rewarding place to work? Ch...
- 11 Days Ago
- Focus Staff
-
Wilmington, DE
FULL_TIME
- Focus Staff is seeking a Progressive Care Unit Registered Nurse for a travel contract in Wilmington, DE. The ideal candidate will have at least 1 year of experience in a PCU setting.Contract Length: 1...
- 15 Days Ago
- Skyline Med Staff Nursing
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Lewes, DE
FULL_TIME
- Job DescriptionSkyline Med Staff Nursing is seeking a travel nurse RN Telemetry for a travel nursing job in Lewes, Delaware.Job Description & RequirementsSpecialty: TelemetryDiscipline: RNStart Date: ...
- Just Posted
- Focus Staff Services
-
Wilmington, DE
OTHER
- OverviewWe currently have a client in Wilmington, DE looking for a Travel L&D RN - Labor & Delivery Registered Nurse!Focus Staff is seeking a traveling Certified Labor & Delivery RN, who will assesses...
- 21 Days Ago
- Focus Staff Services
-
Seaford, DE
OTHER
- OverviewFocus Staff is seeking a Telemetry Registered Nurse for a travel contract in Seaford, DE. The ideal candidate will have at least 1 year of experience in a Telemetry setting. Contract Length: 1...
- 1 Month Ago
Staff Nurse - RN, Sr. - Medical Management jobs at Popular Companies
- University Health System- San Antonio
-
San Antonio, TX
- University Health is Bexar County and South Texas' first health system to earn Magnet status from the American Nurses Cr...
- 4/25/2024 12:00:00 AM
- Good Samaritan Society
-
Central City, NE
- Create Your Career With Us! Join our not-for-profit organization that has provided over 100 years of housing and service...
- 4/24/2024 12:00:00 AM
- Good Samaritan Society
-
Central City, NE
- Create Your Career With Us! Join our not-for-profit organization that has provided over 100 years of housing and service...
- 4/24/2024 12:00:00 AM
- Berkshire Health Systems
-
Pittsfield, MA
- **This is North Adams Regional Hospital (NARH) position. The position will start as a BMC position in Pittsfield, then t...
- 4/24/2024 12:00:00 AM
- East Carolina University
-
Greenville, SC
- Job Title Staff Nurse Position Number 400290 Vacancy Open to All Candidates Time-Limited No Department Homepage https://...
- 4/24/2024 12:00:00 AM
- University Health System
-
San Antonio, TX
- PRN 200 N. Comal Nursing Rotating Shifts POSITION SUMMARY/RESPONSIBILITIES Provides basic leadership skills for assigned...
- 4/24/2024 12:00:00 AM
- Regenirex LLC
-
Kearney, NE
- Job Description Job Description We are seeking a Staff Nurse to join our team! You will be responsible for collecting pa...
- 4/23/2024 12:00:00 AM
- Rutgers University
-
New Brunswick, NJ
- Rutgers, The State University of New Jersey, is seeking a Staff Nurse for the Clinical Research Center at the Robert Woo...
- 4/22/2024 12:00:00 AM