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)
Johns Hopkins Intrastaff is the internal staffing agency for the Johns Hopkins Health System and partner hospitals, providing temporary support to a variety of the Johns Hopkins locations. Our employees are the strength of our service. Intrastaff is unique because it's one of the very few agencies where a person has the benefit of being a temporary employee and also feels like a member of a large organization. Working at Hopkins means joining a culturally diverse team that includes some of the best nurses, physicians and allied health professionals in the world. Directly or indirectly, you'll have exposure to cutting-edge technology and groundbreaking medical research.
Facilitating and coordinates of programs that may include hospital inpatients, outpatients, families, community, and employees of both the hospital and the university by providing evidence-based care based on the nursing process, policies, procedures, and protocols of the Johns Hopkins Hospital.
Providing direction to/management of other team members to promote quality, safety, and excellence in care.
Working collaboratively with, and providing leadership for, a multidisciplinary health care team to support program initiatives that support quality, safety, and excellence in care.
Participating in promoting and identifying quality improvement initiatives (clinical, financial, operational) that supports, protects and promotes area of specialty.
Initiating and participate in the research activities relevant to specialty area.
Implementing initiatives in area of specialty as directed by nursing and medical leadership.
Fostering a clinical environment of service excellence.
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0 Staff Nurse - RN - Medical Management jobs found in Glen Burnie, MD area