TravelNurseSource is working with Cynet Health to find a qualified Case Manager RN in Apple Valley, California, 92307!
Pay Information
$1,932 per week
About The Position
Job Title : Registered Nurse
Profession : Nursing
Specialty : Utilization Review
Duration : 16 weeks
Shift : Day
Hours per Shift : 8
Experience : Minimum of 2 years in Utilization Review with hospital experience.
License : Valid Registered Nurse license.
Certifications : Relevant certifications in Utilization Review.
Must-Have :
Experience with Epic charting system required.
Prior experience in performing utilization review in a hospital setting.
Knowledge of Medicare regulations and specific utilization management processes.
Familiarity with InterQual criteria and other utilization review tools.
Ability to work in Pacific Standard Time.
Flexibility to rotate between multiple facilities.
Description :
The role involves conducting utilization review for acute medical cases.
Candidates will assess admission criteria and evaluate medical necessity for patient services.
Experience in concurrent, continued stay, and retrospective reviews is essential.
Proficiency in utilizing coding and billing systems is required.
Knowledge of HIPAA guidelines and regulations is necessary.
Familiarity with audits, appeals, and denial management will be an asset.
Candidates should have experience with HEDIS measures and CMS guidelines.
The position requires flexibility in scheduling, including weekend shifts.
Strict adherence to labor laws regarding work hours, lunches, and breaks is necessary.
Travel between facilities within the same state is expected.
A commitment to working three holidays during the contract period is required.
Candidates must maintain communication devices as needed for job functions.
References covering at least one year in a comparable specialty are required.
28649865EXPPLAT
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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