Find JobsSalary EstimateCareer AdviceUpload ResumeEmployers / Post JobProfileMessage Center

Travel Nurse RN - Case Manager - $2,125 per week in Hanover, MD

Cynet Health

Hanover, MD

Apply
JOB DETAILS
SALARY
$2,125.40–$2,125.40
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, 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: 13 weeks Shift: Day Hours per Shift: 8:00 AM - 4:30 PM Experience: Minimum of 5 years RN experience License: Active RN License Certifications: Current experience in Utilization Review Must-Have: Current experience with EPIC and referral platforms such as NaviHealth or AllScripts. Proficiency in using InterQual and/or Milliman criteria software systems. Managed care experience in utilization review for at least 1 year preferred. Description: The Utilization Review Nurse is responsible for the day-to-day management of health plan members in acute care and rehabilitative facilities. The Utilization Review Nurse actively monitors the appropriateness of care received by plan members in various settings, including acute hospitals and acute rehabilitation facilities. The Utilization Review Nurse applies member benefit and medical criteria to determine authorization of services in coordination with medical directors. The Utilization Review Nurse proactively initiates discharge planning for members, including identification of post-discharge needs and coordination of post-discharge referrals/services. The Utilization Review Nurse communicates verbally and in writing authorization and/or denial of covered services with providers, facilities, and members. The Utilization Review Nurse is a member of administrative and clinical teams in their area of assignment. Clinical knowledge is maintained and updated, and the Utilization Review Nurse must maintain acceptable documentation and quality standards. Skills: Excellent verbal and written communication skills to effectively interact with enrollees, physicians, facility staff, and management staff. Excellent interpersonal skills and attitude to effectively project a positive image of the Managed Care Program. Strong computer skills and experience with various applications and online systems. Knowledge of utilizing various criteria sets, such as InterQual. Ability to negotiate and resolve conflicts with external customers.

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/