Travel Nurse RN - Case Manager - $2,128 per week in Hanover, MD

Cynet Health

Hanover, MD

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JOB DETAILS

SALARY

$2,128.20–$2,128.20

SKILLS

Case Management, Certified Case Manager (CCM), Communication Skills, Denial of Service (DoS), Discharge Plans, Documentation Standards, Healthcare, Image Management, Interpersonal Skills, Managed Care, Negotiation Skills, Nursing, Patient Care, Presentation/Verbal Skills, Project/Program Management, Quality Metrics, Registered Nurse (RN), Utilization Management, Writing Skills

LOCATION

Hanover, MD

POSTED

11 days ago

Job Title: Utilization Review Nurse Profession: Nursing Specialty: Utilization Management Duration: 13 Shift: Day Hours per Shift: 8:00 AM - 4:30 PM Experience: 5 years RN experience, 1 year Utilization Review experience preferred License: Active RN License Certifications: None specified Must-Have: Proficiency in InterQual and/or Milliman criteria software systems Description: This position is a medical review role with no direct patient care involved. The Utilization Review Nurse monitors the appropriateness of care for members in various settings, including acute and rehabilitative facilities. The Nurse applies medical criteria to determine authorization of services in coordination with medical directors. Initiating discharge planning for members is a key responsibility, including identifying post-discharge needs and coordinating referrals and services. Communication of authorization and denial of services, both verbally and in writing, with providers, facilities, and members is required. The Nurse works as part of both administrative and clinical teams. Maintaining and updating clinical knowledge is essential, as is adherence to documentation and quality standards. Excellent verbal and written communication skills are necessary for effective interaction with enrollees and healthcare staff. Strong interpersonal skills are needed to project a positive image of the Managed Care Program. The ability to negotiate and resolve conflicts with external customers is crucial. Proficiency in using a variety of applications and online systems is 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/