Staff Nurse - RN - Medical Management coordinates with care providers and plan members with the goal of maximizing member benefits while managing costs. Assesses medical necessity of procedures and/or admissions, conducts pre-certification or authorization, and monitors compliance with established guidelines. Being a Staff Nurse - RN - 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 - Medical Management typically requires a bachelor's degree in nursing. Typically reports to a manager. Requires a valid state RN license. To be a Staff Nurse - RN - Medical Management typically requires 3-5 years of related experience. Gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. (Copyright 2024 Salary.com)
Registered Nurse/Care Manager - Broward County
Firstat RN Care Management Services , a leading Care Management Company in Florida, is seeking a proficient and dynamic Registered Nurse to join our esteemed team in Broward County. This position offers the unique opportunity to work with us and train to become and Registered Nurse Care Manager. As a pivotal member of our Care Management Team, you will have the chance to to significantly impact the lives of clients living with complex and or chronic conditions. Many of these clients face multiple barriers that impede their ability to achieve the self-care necessary for improving their health and over all well-being.
Responsibilities:
* Adapt to the varying needs of clients on a day -to- day basis, providing personalized care management services.
* Conduct home visits and telephonic consultations with families to assess client needs and deliver appropriate care.
* Serve as an advocate for clients in communities, collaborating closely with physicians and inpatient facilities.
* Demonstrate flexibility and creative problem -solving skills to address client challenges effectively.
Requirements:
* Graduate of an Accredited Nursing Program with a valid RN Florida License.
* Case/Care Management experience required
* Home Health experience required.
* Valid Florida Drivers License and Automobile insurance.
* Strong goal orientation with the ability to think outside the box and find innovative solutions.
* Excellent written and verbal communication skills.
* Familiarity with personal computer use in a Windows and Excel environment .
Work hours:
Monday through Friday, flexible hours to accommodate client needs.
Occasional on Call duties on a rotational basis throughout the year.
Benefits:
* Mileage reimbursement
* Competitive salary and comprehensive benefit package available.
If you are a dedicated Registered nurse looking for a rewarding career that allows you to make a real difference in people's lives, we invite you to forward your resume for review . If selected, you will have the opportunity to schedule an interview and learn more about the exciting possibilities at Firstat RN Care Management Services.
We appreciate your interest in joining our team and will contact selected candidate to schedule interviews.
Job Type: Full-time
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Work Location: Multiple locations