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Travel Nurse RN - Case Manager - $2,233 per week in Grand Rapids, MI

Cynet Health

Grand Rapids, MI

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JOB DETAILS
SALARY
$2,233–$2,233
SKILLS
Acute Care, Behavioral Health, Case Management, Certified Case Manager (CCM), Clinical Information, Clinical Nursing, Documentation, Establish Priorities, Health Education, Health Plan, Healthcare, Healthcare Providers, Home Care, Nursing, Patient Care, Problem Solving Skills, Process Improvement, Quality of Care, Registered Nurse (RN), Regulations, Resource Management, Social Work, Utilization Management
LOCATION
Grand Rapids, MI
POSTED
Today
Job Title: RN - Utilization Management Clinical Reviewer Profession: Nursing Specialty: Utilization Management Duration: 13 weeks Shift: Day shift Hours per Shift: 8 hours (8 AM - 5 PM) Experience: Minimum of 2 years in acute care or clinical nursing with relevant experience in utilization management License: Registered Nurse (RN) - State License required Certifications: RN License required Description: Provides health information and acts as a resource for providers in complex clinical situations to ensure appropriate use of acute medical and behavioral health care services. Assesses the appropriateness of requests for admissions and continued stay. Educates healthcare professionals regarding utilization management and quality requirements. Makes recommendations and provides financial and utilization management information to care facilitation teams for work prioritization. Works closely with care facilitators, social workers, home health agencies, and providers to ensure proper patient movement through the continuum of care. Completes medical necessity reviews for designated services across various health plans. Assesses and interprets clinical information to assist in case management of complex patient populations using independent judgment and problem-solving skills. Ensures documentation and processes comply with regulatory standards. Communicates with physicians, social workers, and other personnel concerning changes in the level of care for complex patient populations. Makes recommendations and discusses alternatives for care. Provides financial and utilization management information to facilitate team members in prioritizing work. Documents instances where services were delayed, inappropriate, refused, or complicated for resource management functions. Identifies quality indicators to facilitate process improvement and education for physicians. Ensures that members are authorized for the most appropriate level of care based on internal and external guidelines. Collaborates with Medical Directors to enhance care delivery.

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/