Nurse Manager, Member Benefit Coordination Jobs

The Nurse Manager, Member Benefit Coordination assesses medical necessity of procedures and/or admissions, conducts pre-certification or authorization, and monitors compliance with established guidelines. Coordinates with care providers and plan members with the goal of maximizing member benefits while managing costs. Being a Nurse Manager, Member Benefit Coordination interprets benefits and guides members to choose to the appropriate providers, projects and resources. Assists members in appeals for denied services. In addition, Nurse Manager, Member Benefit Coordination typically requires a s ... pecial degree of Nursing or its equivalent. Typically reports to a manager. Requires RN license. Working as a Nurse Manager, Member Benefit Coordination 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. More
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