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Travel Nurse RN - Case Manager - $1,954 per week in Santa Rosa, CA

Cynet Health

Santa Rosa, CA

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JOB DETAILS
SALARY
$1,953.50–$1,953.50
SKILLS
Acute Care, Case Management, Certified Case Manager (CCM), Current Procedural Terminology (CPT), Discharge Plans, HIPAA (Health Insurance Portability and Accountability Act), Health Maintenance Organization (HMO), ICD-10, Medicare, Nursing, Organizational Skills, Patient Care Authorizations, Registered Nurse (RN), Regulations, Utilization Management
LOCATION
Santa Rosa, CA
POSTED
Today
Job Title: Remote Utilization Review Registered Nurse Profession: Nursing Specialty: Utilization Review Duration: 13 Weeks Shift: Day 5x8-Hour Hours per Shift: 8 Experience: Minimum Years of Experience: 3 License: Registered Nurse Certifications: Required certifications related to utilization review Must-Have: Experience in acute hospital settings. Proficient in using charting systems. Experience with Medicare regulations related to utilization management processes. Ability to work in Pacific Standard Time. Description: The position involves performing utilization reviews in a remote setting. Candidates must have three years of acute hospital experience. Experience with InterQual criteria is required. Candidates must have experience with HMOs, IPAs, and related processes. Knowledge of admission criteria, appeals, denials, and insurance benefits eligibility is essential. Ability to coordinate care and conduct concurrent and retrospective reviews is necessary. Familiarity with HIPAA guidelines and medical necessity determination is required. Candidates should be skilled in discharge planning, disability case management, and care coordination. Experience with CPT and ICD-10 coding is necessary. Candidate flexibility is required as the role supports multiple facilities. Travel between facilities may be necessary. Commitment to working three out of five major holidays is required. References will be required covering recent experience. Must adhere to all relevant labor laws and policies regarding work schedule and breaks. Regular compliance with documentation and reporting requirements is expected. Modules and ongoing education related to the role are part of the job requirements.

About the Company

C

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/