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)
TLC Nurse Solutions is a family and women-owned registry.
We are inviting qualified and compassionate Independent Contractor RNs to join our registry. We provide access to a diverse range of assignments for clinicians throughout California.
Responsibilities:
Requirements:
**This is a possible temp to perm position
Job Type: Contract
Pay: $70.00 - $85.00 per hour
Expected hours: 40 per week
Standard shift:
Weekly schedule:
Application Question(s):
Experience:
License/Certification:
Work Location: In person
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0 Staff Nurse - RN - Medical Management jobs found in Santa Clara, CA area