Travel Registered Nurse (RN) - Case Manager - $2,815 per week in Duarte, CA

TravelNurseSource is working with Cynet Health to find a qualified Case Manager RN in Duarte, California, 91010!

Pay Information

$2,815 per week

About The Position

Job Title : Utilization Review Registered Nurse

Profession : Registered Nurse

Specialty : Utilization Review

Duration : 8 weeks

Shift : Night

Hours per Shift : 8 hours

Experience : 3 years required

License : Active nursing license required

Certifications : BLS required; CM certification preferred

Must-Have :

EPIC experience required

Charge experience preferred

Description :

Utilization Review RN position available.

Experience with EPIC and InterQual documentation systems is necessary.

Practices SBAR communication for provider support.

Interdisciplinary support includes various specialized services.

Business casual dress is required.

Three years of experience in relevant fields is required.

Experience must include acute hospital settings.

Familiarity with various aspects of care coordination is essential.

Responsibilities include concurrent and retrospective reviews.

Utilization of evidence-based guidelines for medical necessity determinations is necessary.

Experience with prior authorizations, appeals, and audits is required.

Knowledge of CPT coding and billing is necessary.

Candidates must be knowledgeable of CMS guidelines and applicable regulations.

Understanding of HEDIS measures and quality improvement initiatives is essential.

Experience with discharge planning and needs assessments is preferred.

Familiarity with managing diverse patient populations, including pediatrics and geriatrics, is required.

Demonstrated competency in documentation and data abstraction is expected.

This role requires effective communication skills, both verbal and written.

Candidates must be able to work collaboratively in an interdisciplinary environment.

Compliance with all required vaccinations is mandatory.

This position may involve reviews related to various insurance and governmental programs.

Prior utilization review experience is preferred.

28736194EXPPLAT

Job Requirements

Required for Onboarding

• BLS
• Pharmacology
• Skills Checklist
• Specialty Exam

About Cynet Health

Your travel nursing adventure begins here. Matching talented nurses like you with high-paying travel jobs at the best facilities across all 50 states. We offer the most competitive pay for every position we fill. We understand this is a partnership. You will have no surprises. Your salary will be discussed upfront and there will be no troubling negotiation tactics.