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Travel Nurse RN - Case Manager - $2,446 per week in Kinston, NC

Cynet Health

Kinston, NC

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JOB DETAILS
SALARY
$2,446–$2,446
SKILLS
Acute Care, Basic Life Support (BLS), Case Management, Certified Case Manager (CCM), Clinical Information, Denials Management, Healthcare Reimbursement, Insurance, Nursing, Quality of Care, Registered Nurse (RN), Support Documentation, Third-Party Payer, Time Management, Utilization Management
LOCATION
Kinston, NC
POSTED
1 day ago
Job Title: Utilization Review Nurse Profession: Registered Nurse Specialty: Utilization Review Duration: 13 weeks Shift: Day Hours per Shift: 8 hours (08:30 - 17:00) Experience: Minimum of two (2) years of Utilization Review experience. Acute hospital experience required. Must have travel experience. License: NC or compact state RN license Certifications: BLS required; ACM/CCM preferred Must-Have: - Utilization Review experience is required. - EPIC experience is required. - Experience in Denials Management, including insurance denials, peer-to-peer interaction, and appeals is preferred. - Experience with completing Utilization Review in the hospital setting and using InterQual and MCG evaluation criteria to justify admissions and level of care with insurance companies. Description: This 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. This role assures timely movement of patients throughout the continuum of care by conducting concurrent reviews and proactively resolving care, service, or transition of care delays or issues as necessary, in collaboration with the care team. The position provides third-party payers with clinical information to assure reimbursement. It coordinates care with the treatment team, patients, families, and others. The role involves communication with physicians for appropriate documentation to support authorization of services.

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/