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)
Client: State of Ohio DOT
Position: Product Specialist 2/PS2- 738578 (100% ONSITE)
Contract: Until 06/30/2025 (with possible extension)
Location: 1980 West Broad St, Columbus, Ohio 43223
Interview: Teams and in-person
Closing Date: 06/3/2024
Job Description:
The candidate will be supporting The Ohio Department of Transportation s (ODOT) Asset Management Team.
This position will function as a skilled PS2 within the Department of Information Technology responsible for tracking, updating, and movement of Information Technology desktop and network assets.
Specific responsibilities:
Years of Relevant Experience: 3 - 4 years
Preferred Education: 4-year college degree or equivalent technical study.