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)
ESHYFT is a mobile app that connects nurses to flexible shifts at long-term care facilities. In 25 states, vetted CNAs, LPNs, and RNs, use ESHYFT’s top-rated nurse app to pick up shifts where they want, when they want. To facilities, ESHYFT is providing a staffing solution, and for nurses, it's empowering them to choose when and where they work. Together, with facilities and nurses, ESHYFT is closing the gap on staffing shortages and providing care to those most vulnerable.
RN Job Summary
The Registered Nurse promotes and restores patients' health by completing the nursing process; collaborating with physicians and multidisciplinary team members; providing physical and psychological support to patients, friends, and families; supervising assigned team members.
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0 Staff Nurse - RN, Sr. - Medical Management jobs found in Vincennes, IN area