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Travel Nurse RN - Case Manager - $2,110 per week in Hanover, MD

Cynet Health

Hanover, MD

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JOB DETAILS
SALARY
$2,110–$2,110
SKILLS
Acute Care, Case Management, Certified Case Manager (CCM), Communication Skills, Computer Skills, Discharge Plans, Documentation Standards, Health Plan Membership, Image Management, Interpersonal Skills, Managed Care, Negotiation Skills, Nursing, Nursing Management, Presentation/Verbal Skills, Production Systems, Project/Program Management, Quality Metrics, Registered Nurse (RN), Utilization Management
LOCATION
Hanover, MD
POSTED
2 days ago
Job Title: Utilization Review Nurse Profession: Registered Nurse Specialty: Utilization Management Duration: 13 weeks Shift: Day Hours per Shift: 8:30 AM - 5:00 PM Experience: - Minimum 5 years of RN experience - Current experience in Utilization Review - Managed care experience preferred License: - Active RN License Certifications: - BLS or MED-TEST not required Must-Have: - Proficiency in InterQual and/or Milliman criteria software systems - Recent experience with referral platforms such as Epic, NaviHealth, or AllScripts - Experience in a high production environment Description: The Utilization Review Nurse is responsible for managing health plan members in acute care and rehabilitative facilities. This position involves monitoring the appropriateness of care received by plan members in various settings. The Utilization Review Nurse applies member benefit and medical criteria to authorize services in coordination with medical directors. Proactively initiating discharge planning for members, including identifying post-discharge needs and coordinating referrals. Effective communication, both verbal and written, is necessary for authorizing or denying covered services with providers and members. The Utilization Review Nurse is a member of clinical and administrative teams in the area of assignment. Maintaining and updating clinical knowledge while ensuring adequate documentation and quality standards is required. This role requires excellent interpersonal skills to project a positive image of the Managed Care Program. Strong computer skills are needed to work with various applications and online systems. Ability to negotiate and resolve conflicts with external customers is essential.

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/

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