Staff Nurse - RN - Medical Management coordinates with care providers and plan members with the goal of maximizing member benefits while managing costs. Assesses medical necessity of procedures and/or admissions, conducts pre-certification or authorization, and monitors compliance with established guidelines. Being a Staff Nurse - RN - 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 - Medical Management typically requires a bachelor's degree in nursing. Typically reports to a manager. Requires a valid state RN license. To be a Staff Nurse - RN - Medical Management typically requires 3-5 years of related experience. Gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. (Copyright 2024 Salary.com)
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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:
RN Facility Educator Responsibilities:
RN Facility Educator Requirements: