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Travel Nurse RN - Case Manager - $2,054 per week in Hanover, MD

Cynet Health

Hanover, MD

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JOB DETAILS
SALARY
$2,054–$2,054
SKILLS
Acute Care, Case Management, Certified Case Manager (CCM), Communication Skills, Computer Skills, Denial of Service (DoS), Discharge Plans, Documentation Standards, Facilities Management, Health Plan Membership, Hospital, Image Management, 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
Today
Job Title: Utilization Review Nurse Profession: Registered Nurse Specialty: Utilization Management Duration: 8 weeks Shift: Day Hours per Shift: 8:00 AM - 4:30 PM Experience: Minimum 5 years of RN experience, 1 year of current Utilization Review experience preferred License: Active RN License Must-Have: - Proficiency with InterQual criteria software systems - Managed care experience in utilization review Description: The Utilization Review Nurse is responsible for the day-to-day management of health plan members in acute care and/or rehabilitative facilities. The Utilization Nurse actively monitors the appropriateness of care received by plan members in various settings, including acute hospitals and rehabilitation facilities. The Utilization Nurse applies member benefits and medical criteria to determine authorization of services in coordination with Medical Directors. The Utilization Nurse proactively initiates discharge planning for members, including the identification of post-discharge needs and coordination of post-discharge referrals/services. The Utilization Nurse communicates verbally and in writing authorization and/or denial of covered services with providers, facilities, and members. The Utilization Nurse is part of administrative and clinical teams in the area of assignment. Clinical knowledge is maintained and updated, and the Utilization Nurse must uphold acceptable documentation and quality standards. Excellent verbal and written communication skills are required to effectively interact with enrollees, physicians, facility staff, and management staff. The role requires excellent interpersonal skills and a positive attitude to project a favorable image of the Managed Care Program. Computer skills are necessary for working with a variety of applications and online systems. The ability to negotiate and resolve conflicts with external customers is essential.

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/