Travel Nurse RN - Case Manager - $1,907 per week in Hanover, MD

Cynet Health

Hanover, MD

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JOB DETAILS

SALARY

$1,907–$1,907

SKILLS

Acute Care, Case Management, Certified Case Manager (CCM), Communication Skills, Denial of Service (DoS), Discharge Plans, Documentation Standards, Facilities Management, Health Plan Membership, Hospital, Interpersonal Skills, Managed Care, Negotiation Skills, Nursing, People Management, Presentation/Verbal Skills, Project/Program Management, Quality Metrics, Registered Nurse (RN), Utilization Management, Writing Skills

LOCATION

Hanover, MD

POSTED

3 days ago

Job Title: Utilization Review Nurse Profession: Registered Nurse Specialty: Utilization Management Duration: 8 months Shift: Day Hours per Shift: 8:00 AM - 4:30 PM Experience: Minimum of 5 years RN experience with current Utilization Review experience License: Active RN License Certifications: Proficiency in InterQual criteria software systems Must-Have: - Managed care experience in utilization review for at least 1 year preferred Description: This position involves the day-to-day management of health plan members in acute care and/or rehabilitative facilities. The Utilization Review Nurse actively monitors the appropriateness of care received by plan members in various settings, including acute hospitals and rehabilitation facilities. The nurse applies member benefit and medical criteria to determine the authorization of services in coordination with medical directors. Proactively initiating discharge planning for members is a key responsibility, including the identification of post-discharge needs and coordination of referrals/services. The nurse communicates authorization and/or denial of covered services verbally and in writing with providers, facilities, and members. As a member of administrative and clinical teams, the nurse maintains and updates clinical knowledge and must uphold acceptable documentation and quality standards. Excellent verbal and written communication skills are essential for effective interaction with enrollees, physicians, facility staff, and management. Strong interpersonal skills and a positive attitude are required to represent the Managed Care Program effectively. Computer skills with various applications and online systems are necessary. Knowledge of standards and criteria sets, including InterQual, is essential. The ability to negotiate and resolve conflicts with external customers is also required.

About the Company

Cynet Health

Cynet Health is a TJC certified MBE and one of the fastest-growing healthcare staffing firms in the US providing Health Med and Health IT staffing and consulting services to countless hospitals, SNFs, clinics, labs, CROs, health & wellness centers, pharmacies, and other medical facilities across the United States. Headquartered in Sterling, Virginia, we are a certified Minority-Owned Business Enterprise and a recognized Diversity Supplier.

COMPANY SIZE

1,000 to 1,499 employees

INDUSTRY

Healthcare Services

WEBSITE

https://cynethealth.com/