How much does a Staff Nurse - RN, Sr. - Medical Management earn in the United States? The average Staff Nurse - RN, Sr. - Medical Management salary in the United States is $84,092 as of March 28, 2019, but the range typically falls between $76,200 and $93,598. Salary ranges can vary widely depending on many important factors, including education, certifications, additional skills, the number of years you have spent in your profession. With more online, real-time compensation data than any other website, Salary.com helps you determine your exact pay target. View Cost of Living in Major Cities
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. Assists members in appeals for denied services. Interprets benefits and guides members to choose to the appropriate providers, projects and resources. 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. 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.
Take just three simple steps below to generate your own personalized salary report.
Includes bonus, healthcare, and retirement
3 - 5 years experience
5 + years experience
Salary.com's CompAnalyst platform offers: