Travel Nurse RN - Utilization Review - $2,457 per week in Kinston, NC

Prime Staffing

Kinston, NC

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JOB DETAILS

SALARY

$2,457.20–$2,457.20

SKILLS

Acute Care, Basic Life Support (BLS), Denials Management, Epic Systems, Equipment Maintenance/Repair, Geriatrics, Health Informatics, Hospital, Insurance, Insurance Certifications, Internet Portal, Medical Diagnosis, Nursing, Patient Care, Patient Care Authorizations, Quality of Care, Registered Nurse (RN), Sales Management, Support Documentation, Time Management, Utilization Management, Willing to Travel

LOCATION

Kinston, NC

POSTED

3 days ago

ID: 63125154 Shift: Day 5x8-Hour (08:30 - 17:00) Description: Utilization Review Nurse*THIS IS NOT A REMOTE POSITION. It is an in person role. s; M-F; 8:30 5pmNo WeekendsNo CallEDUCATIONGraduate from an accredited school of nursing, BSN preferred.EXPERIENCEMinimum of two (2) years of Utilization Review experience. EPIC experience is requiredAcute Hospital experience is requiredMust have travel experience. Review experience required. Experience in Denials Management Insurance Denials, Peer-to-peer, 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 companiesLICENSURE /CERTIFICATIONNC or compact state RN licenseBLS RequiredACM/CCM Preferred Average daily census : 30Orientation: 24 hoursThis position facilitates utilization management processes to support the right care is provided at the right place at the right time. To accomplish these goals, the UR, Nurse applies established criteria to evaluate the appropriateness of admission, level of care, continued hospitalization and readiness for care transition; assures timely movement of patients throughout the continuum of care by conducting concurrent review and proactively resolving care, service, or transition of care delays/issues as necessary; in collaboration with the care team. This position provides third-party payers clinical information to assure reimbursement; and coordinating care with the treatment team, patient, family, and others. Communicates with physicians for appropriate documentation to support authorization of services. Modified 4:00:00 AM Account Manager: Haley Hindes Account Manager Email: COVID-19 Vaccine: Unknown Flu Vaccine: Unknown Job Requirements & Qualifications Previous Charge Experience : - Years of Experience : 2 Patient Ratio Experience : Charting System Experience : Required Charting System Name : Epic Community Hospital Experience : Preferred LTAC Experience : - Trauma Level I Experience : - Trauma Level II Experience : - Travel Experience Required : Yes Certifications : BLS, RN state license, ACM/CCM*Skills : Acute Hospital, Admission Criteria, Admission Criteria, Appeals and Denials*, Appeals and Denials*, Concurrent Review, Concurrent Review, Continued Stay Reviews, Continued Stay Reviews, Determine Medical Necessity per Evidence-Based Guidelines, Medical Necessity, Pre-Cert Review*, Prior Authorization, Prior Authorizations, Retrospective Review*, Retrospective Review*, Utilize InterQual Criteria, Utilize InterQual Criteria, Utilize Milliman Guidelines, Utilize Milliman Guidelines, Payor Portals* Unit Details Staffing & Scheduling Scheduling Type : - Patient Ratios Days : - Patient Ratios Nights : - Patient Ratios Weekends : - Float Required : - Call Required : - Weekend Coverage : - Number of Weekend Shifts Per Contract : - Pre-Approved Time Off : - Orientation Hours : 24 Facility & Patient Care Details Patient Age Groups : Adults, Geriatrics Daily Census : 30 Number of Visits Per Day : - Number of Rooms : - Number of Beds : - Additional Unit Information Interdisciplinary Support : - Patient Diagnoses : Utilization Review experience required. Experience in MCG and Interqual required.Experience in Denials Management Insurance Denials, Peer-to-peer, Appeals is preferred. Experience in payor portals/reviewing portals for authorization/denial determination preferred. Special Procedures/Unit Details : This position facilitates utilization management processes to support the right care is provided at the right place at the right time. To accomplish these goals, the UR, Nurse applies established criteria to evaluate the appropriateness of admission, level of care, continued hospitalization and readiness for care transition; assures timely movement of patients throughout the continuum of care by conducting concurrent review and proactively resolving care, service, or transition of care delays/issues as necessary; in collaboration with the care team. This position provides third-party payers clinical information to assure reimbursement; and coordinating care with the treatment team, patient, family, and others. Communicates with physicians for appropriate documentation to support authorization of services. Special Equipment : - #Tier1 Travel Compliance Submittal Details: #Tier1 Travel Compliance Guaranteed Hours: Contract Weeks:91

About the Company

Prime Staffing

Prime Staffing is one of New York's leading staffing firms specializing in temporary and full-time/permanent placements across multiple industries including; healthcare, business, consulting, finance, legal services, entertainment, media, information Technology(IT) and retail.

Prime Staffing is certified by The Joint Commission for its compliance, and integrity, in supplying superior healthcare staffing services to many of the finest healthcare organizations in the country. In addition to its impeccable reputation for providing travel and per diem health care staffing, Prime has become an integral partner in staffing some of the most prestigious business organizations and Fortune 500 companies in the country including multi-national bank and investment firms, international business consulting firms, global law firms and some of the most prominent media and entertainment outlets.

Prime's success and rapid growth is direct result if its most basic founding principle-provide our clients with the most experienced and qualified employees and, likewise, provide our employees with the best jobs at the top organizations in their respective professional disciplines.

Prime Staffing is a high-energy company with a corporate culture that embraces innovation, new technology and personalized customer service. We are confident in our ability to serve you professionally by placing esteemed and experienced individuals. Our continuous expansions enables us to adapt to the continuously changing needs of our clients and employees. Through our team of seasoned professionals we maintain respect, integrity and superiority in all aspects of our business.

At Prime, we work diligently to recognize your objectives and create programs to meet them. We believe that ardent customer service is an essential component to remaining at the forefront of a competitive marketplace. Prime utilizes its expertise, and decades of combined experience in the industry, to continuously improve, implement cutting-edge programs and maintaining our position in the market as one of the fastest growing firms in the Tri-State area.

It is our goal to build long-term relationships with clients and employees based on a foundation of trust, mutual respect and our expertise in the field of staffing. We guarantee dependability, consistency and security in all aspects of operation. Prime Staffing is the Superior Staffing Solution.

COMPANY SIZE

100 to 499 employees

INDUSTRY

All

WEBSITE

http://www.primestaffingnyc.com/

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