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)
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Location: Wheeling, WV
Position: RN OR
Shift: Days
Duration: 13 weeks
Weekly Gross: $ 3,080 (based on 40 hours)
Common Cases All procedures including same day and overnight stays Experience or 'Must have' skills IV skills a must. Surgical care knowledge Scrubbing required -
Floating Requirements OR holding area
Scrub Color/Dress Code provided by facility
Unit/Department specific orientation Surgical Center/pre op
Additional Notes this is a preop area that we call surgical center so it is not a free standing surgical center
Submission Requirements Reminders(Disregard if completed)
https://rnstaff.com/skills-checklists/
Ann Dizon
Account Manager
317 328 2866
ann@rnstaff.com