Registered Nurse (RN) | Case ManagerLocation: Kinston, NCAgency: Cynet HealthPay: $2,346 per weekShift Information: Days - 5 days x 8 hoursContract Duration: 13 WeeksStart Date: 6/8/2026
Job Title: Utilization Review NurseProfession: Registered NurseSpecialty: Utilization ReviewDuration: 13 weeksShift: DayHours per Shift: 8Experience: Minimum of two (2) years of Utilization Review experience.License: RN licenseCertifications: BLS Required; ACM/CCM PreferredMust-Have:- Acute Hospital experience- EPIC experience- Travel experience- Denials Management experience preferredDescription:This is not a remote position.It is an in-person role.The shift consists of Monday through Friday from 8:30 AM to 5:00 PM.No weekends and no call are required.The position facilitates utilization management processes to ensure the right care is provided at the right place and at the right time.The Utilization Review Nurse applies established criteria to evaluate the appropriateness of admission, level of care, continued hospitalization, and readiness for care transition.Timely movement of patients throughout the continuum of care is assured by conducting concurrent reviews.Proactively resolving care, service, or transition of care delays or issues is necessary and is done in collaboration with the care team.This position provides third-party payers with clinical information to support reimbursement.Coordination of care is done with the treatment team, patients, families, and others.Effective communication with physicians is essential for appropriate documentation to support authorization of services.Experience in utilizing InterQual and MCG criteria for admissions and level of care is required.Experience with reviewing portals for authorization and denial determinations is preferred.
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.