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)
Description
Job Schedule: Full TimeWork where every moment matters.
Every day, over 30,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut's most comprehensive healthcare network.
St. Vincent's Medical Center in Bridgeport has more than 3,200 employees. It includes a 473-bed community teaching hospital, a 76-bed inpatient psychiatric facility in Westport, a large multispecialty provider group, and special needs services for adults and children. St. Vincent's is the first hospital in Fairfield County to be integrated into the Hartford HealthCare network, and is the system's second-largest hospital.
Job description:
The Nursing Professional Development (NPD) Practitioner is a Register Nurse with NPD practice judgement and expertise who influence professional role competence and growth of learners. The NPD practitioner is responsible for supporting learners within the context and framework of the Nursing Professional Development, Scope and Standards practice as approved by the American Nurses Association.
This position works in collaboration with nursing leadership to foster and influence competency management, clinical nursing education, professional role development, policy standardization, collaborative partnerships, scientific inquiry, transition to practice and onboarding/orientation of new Hartford HealthCare colleagues.
The practitioner is an essential member of the nursing leadership team who promotes the alignment of regional NPD and practice excellence with the HHC system as a whole.
Role Responsibilities:
Qualifications
Knowledge, Skills and Ability Requirements
Committed to nursing excellence, St. Vincent's Medical Center in Bridgeport is a twice-designated Magnet hospital. With more than 3,200 employees, it includes a 473-bed teaching hospital, a 76-bed inpatient psychiatric facility and special needs services for adults and children. St. Vincent's is also a Level 2 Trauma Center, certified by the American College of Surgeons, Committee on Trauma. Now part of Hartford HealthCare, it is the fastest growing hospital in the state providing more advanced surgical procedures and expanding access to care. A large provider group, comprised of the region's foremost experts, provides convenient patient access from Stamford to Milford and nearly everywhere in between. Founded in 1903, St. Vincent's remains steadfast in its mission to provide compassionate, personalized care to the community.
St. Vincent's Medical Center is part of Hartford HealthCare, a system that includes 7 acute care hospitals, a comprehensive Behavioral Health Network, Home Care services, Senior Services, and an extensive Medical Group network. Hartford HealthCare's unified culture enhances access, affordability, equity and excellence. Its care-delivery system of over 37,000 employees- in more than 500 locations serving 185 towns across Connecticut offers unparalleled expertise-touching more than 23,000 lives every single day. Here you'll learn, grow, and contribute to healing and health as part of one of Connecticut's premier health systems. No matter where you work in the Hartford HealthCare system, you're connected to the team that's redefining care. Start here, where every moment matters.
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0 Staff Nurse - RN, Sr. - Medical Management jobs found in Bridgeport, CT area