TravelNurseSource is working with Cynet Health to find a qualified Case Manager RN in Duarte, California, 91010!
Pay Information
$1,678 per week
About The Position
Job Title : Utilization Review RN
Profession : Registered Nurse
Specialty : Utilization Review
Duration : 13 weeks
Shift : Day
Hours per Shift : 12 hours
Experience : 3 years required
License : Must have current state nursing license
Certifications : BLS required, CM certified preferred
Must-Have :
EPIC experience required
Previous charge experience preferred
Description :
Utilization Review RN responsible for patient care coordination and quality assurance.
Utilizes EPIC and InterQual documentation systems.
Conducts SBAR communication effectively.
Provides support to various providers including Interpretation Services, Pharmacy, and Social Services.
Experience in acute hospital settings is required.
Knowledge of admission criteria, appeals, and denials processes is essential.
Familiarity with concurrent reviews and continued stay reviews is expected.
Proficient in determining medical necessity per evidence-based guidelines.
Experience with discharge planning and disease management is necessary.
Utilizes appropriate coding and billing practices.
Understands regulatory requirements related to healthcare.
Experience with CMS guidelines, HEDIS measures, and HIPAA regulations is important.
28427850EXPPLAT
Job Requirements
Required for Onboarding
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.
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