Travel Nurse RN - Case Manager - $2,000 to $2,300 per week in Arcata, CA

TravelNurseSource is working with Job.com to find a qualified Case Manager RN in Arcata, California, 95518!

Pay Information

$2,000 to $2,300 per week

About The Position

Job Summary

We are seeking an experienced and detail-oriented Registered Nurse (RN) for Utilization Review to join our team. In this role, you will be responsible for reviewing medical records, evaluating clinical information, and ensuring that healthcare services provided to patients meet established quality and medical necessity guidelines. You will work closely with physicians, case managers, and insurance providers to support optimal patient care and cost-effective healthcare delivery.

Key Responsibilities

Review and evaluate patient medical records for accuracy, completeness, and compliance with regulatory guidelines.

Assess medical necessity and appropriateness of inpatient and outpatient services based on evidence-based criteria (e.g., InterQual, MCG).

Collaborate with healthcare providers to ensure documentation supports the level of care being delivered.

Communicate with insurance companies to obtain authorizations and resolve coverage issues.

Identify and escalate cases that require physician advisor or medical director review.

Provide utilization management education and guidance to clinical staff.

Maintain up-to-date knowledge of payer policies, regulations, and industry best practices.

Document all utilization review activities in compliance with hospital and HIPAA standards.

28150719EXPPLAT

About Job.com

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Why Clinical Staff Choose Job.com Healthcare?

At Job.com Healthcare team is proud of the support and competitive benefits we offer our clinical talent. We recognize the need for personalized packages that meet the lifestyle of our nursing staff, as well as the importance of providing access to resources around the clock, any day, whenever they need us. Clinicians and travelers continue to work with our teams because we’re dedicated to their wellness and success, further lessening the burden and stress on our customer facilities and partners.

• Personalized pay packages
• Day 1 Insurance
• Licensure and credentials reimbursements are available
• Weekly Pay
• 401K Program
• Clinical support from on-site Clinical Director