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)
We're looking to build its team of RNs. As a Nursing TEAM member, you will be an integral partner in providing the best possible care for our residents.
$10,000.00 SIGN ON BONUS
Duties include but are not limited to:
Qualifications and Skills: Must be licensed in the state of Oklahoma and pass a background check.
Benefits: We offer a comprehensive benefit package that includes medical, dental and vision coverage as well as employer sponsored life insurance.We have both full and part time positions available. If you are interested in joining the team during this EXCITING time of change and growth, please respond with your resume. Thank you!
*** No inquiries from staffing agencies/recruiters.
Job Type: Full-Time or Part-TIme
Must currently possess a license as a RN or LPN (Required)