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)
An award-winning critical access hospital located in southern New Hampshire is currently searching for an experienced Manager Medical Staff Services to join their dynamic healthcare team.
This regional leading healthcare organization offers a wide range of clinical services including medical, surgical, intensive care, obstetrics, pediatrics, emergency care, mental health, and primary care services. This facility opened its doors just over 100 years ago and has since proved a timeless commitment to improving the health and well-being of the surrounding communities.
Reporting to the Chief Medical Officer, the Manager Medical Staff Services is responsible for ensuring that physicians and advanced practice providers possess the necessary credentials and qualifications to deliver quality patient care in compliance with regulatory requirements and accreditation standards. You will lead a team, supervise staff, and collaborate with various stakeholders to streamline and enhance the medical staff credentialing and privileging processes. Your strong knowledge of medical staff bylaws, policies, and procedures, along with your exceptional attention to detail and organizational skills, will contribute to the efficient functioning of the medical staff services, promoting patient safety and quality outcomes.
What Makes You Awesome:
Located in southern New Hampshire, this picturesque region offers a blend of natural surroundings, cultural heritage, and community spirit. This location offers high quality of life, with a range of recreational, cultural, and educational opportunities that make it an appealing place to live or visit.
This organization is prepared to offer a competitive salary including an industry leading benefit package for those who qualify.
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0 Staff Nurse - RN - Medical Management jobs found in Nashua, NH area