Travel Nurse RN - Case Manager - $2,976 per week in Albuquerque, NM

TravelNurseSource is working with Cynet Health to find a qualified Case Manager RN in Albuquerque, New Mexico, 87110!

Pay Information

$2,976 per week

About The Position

Job Title : RN Utilization Review / Case Manager

Profession : RN

Specialty : Utilization Review / Case Management

Duration : 13 weeks

Shift : 0800-1630

Hours per Shift : 8 hours

Experience : Five years of experience in clinical nursing, with a minimum of two years in emergency or acute clinical, utilization review, or case management within the last ten years.

License : New Mexico RN license required.

Certifications : BLS required.

Must-Have : Computer knowledge, including Windows, Word, Excel, and database systems.

Description :

Floating between departments and local locations within 20 miles is required.

Coordinating patient care across the continuum using assessment, care planning, implementation, coordination, monitoring, and evaluation for cost-effective and quality outcomes in a primarily inpatient setting is essential.

Responsible for facilitating member transfers when services are available.

Coordinates and facilitates the transfer of patients using the transfer center process flows.

Once the decision for admission is made, collects clinical information to determine patients' level of care.

Collaborates with the transfer center for the transfer of members.

Conducts an in-depth assessment, which includes psychosocial, physical, medical, environmental, and financial parameters.

Collaborates with the healthcare team to proactively develop, implement, and document treatment and discharge plans, addressing social, physical, mental, emotional, spiritual, and supportive needs.

Formulates, implements, coordinates, monitors, and evaluates strategies with the healthcare team to address care management issues for specific patients and disease processes.

Applies utilization review criteria to assess and document the appropriateness of admission, continued stay, level of care, and readiness for discharge; refers cases that do not meet criteria to the designated Physician Advisor.

Promotes the appropriate use of clinical and financial resources to improve quality of care and patient / member satisfaction.

Performs cost-benefit analyses and refers to negotiations as needed with non-contracted providers and vendors.

Generates reports demonstrating efficacy through direct cost-savings and outcome measures.

Actively participates in the development of clinical guidelines and pathways and incorporates processes into the role of nurse care coordinators.

Educates providers and other departments on health management strategies and care coordination services.

Receives, reviews, verifies, and processes requests for approval of pre-service and concurrent services, supplies, and / or procedures, including but not limited to inpatient hospitalizations, diagnostic testing, outpatient procedures and services, home health care services, durable medical equipment, and rehabilitative therapies.

Performs retrospective review and conducts audits at provider locations, completing all documentation accurately and appropriately.

Upon completion of medical record validation and other retrospective audits, compiles detailed findings and relevant supporting documentation for review.

Performs other functions as required.

28544269EXPPLAT

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.