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)
Focus Staff is seeking a traveling RN Case Manager for our client in Alliance, NE .
Contract Assignment – 13 Weeks (Temporary)
Shift: 5x8 Days
Rewards: (RN Case Manager Benefits)
Requirements:
Responsibilities:
If You have the Passion to be a RN Case Manager, Apply Today and a Recruiter will guide you through the Process!
Join our VIP team of Traveling Professionals!
About the Company:
Focus Staff