Travel Nurse RN - Case Manager, Utilization Review - $3,604 per week

Requirements

• None specified.
• Additional Information: This role requires strong interpersonal skills to collaborate with physicians, health providers, payor sources, and the general public.
• QUALIFICATION/LICENSURE
• Work Authorization : US Citizen
• Preferred years of experience : 1 years
• Travel required : No travel required
• Shift timings :
• RightSourcing IHS Job ID #37276836. Pay package is based on 8 hour shifts and 40 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: RN-Case Management (Utilization Review)
• Why Vivian Health?
• Be sure to apply via Vivian Health to increase your chances of landing your perfect job. Just complete your Vivian Health profileonce, and get access to thousands of opportunities across the country. Then keep up to date with your job application process and conversations with our easy to use app.
• Specialty: Utilization Review
• Discipline: RN
• Duration: 9 weeks
• 40 hours per week
• Shift: 8 hours
• Employment Type: Travel
• Job Title: RN - Case Management (Utilization Review)
• Location: California
• Employment Type: Full-Time
• Contract Length: Permanent
• Job Summary: The Utilization Review Nurse II is responsible for evaluating medical records, discharge planning, and ensuring compliance with payor documentation requirements to maximize hospital reimbursement.
• Job Responsibilities:
• Evaluate medical records for inpatient admissions to ensure required documentation is present.
• Initiate Physician Advisories for unwarranted admissions.
• Conduct ongoing reviews and discuss care changes with attending physicians.

Additional Information

Integrated Healthcare Services is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Bakersfield, California. Job Description & Requirements Specialty: Utilization Review Discipline: RN Duration: 9 weeks 40 hours per week Shift: 8 hours Employment Type: Travel Job Title: RN - Case Management (Utilization Review) Location: California Employment Type: Full-Time Contract Length: Permanent Job Summary: The Utilization Review Nurse II is responsible for evaluating medical records, discharge planning, and ensuring compliance with payor documentation requirements to maximize hospital reimbursement. Job Responsibilities: Evaluate medical records for inpatient admissions to ensure required documentation is present. Initiate Physician Advisories for unwarranted admissions. Conduct ongoing reviews and discuss care changes with attending physicians. Formulate and document discharge plans. Coordinate with hospital services to ensure efficient resource use. Identify pay source issues and provide appropriate referrals. Collaborate with admitting office to prevent inappropriate admissions. Schedule specialized tests and authorize payments under Medically Indigent Adult programs. Review and approve surgery schedules for elective procedures. Coordinate with correctional facilities regarding elective procedures and medical goods. Answer provider questions about reimbursement and documentation requirements. Teach providers payor documentation requirements to maximize reimbursement. Assist in training Utilization Review Nurse I staff. Perform other job-related duties as assigned. Required Qualifications: Two (2) years of experience as an RN in an acute care hospital, including one (1) year on a medical/surgical ward or unit. One (1) year of utilization review/discharge planning experience in an acute care hospital or two (2) years as a Case Manager in a clinic or physician's office. Knowledge of payor source documentation requirements and governmental regulations. Understanding of acute care nursing principles, patient disease processes, medical terminology, and hospital routines. Ability to evaluate medical records, assess clinical performance, and communicate documentation needs effectively. Proficiency in gathering and analyzing data for reports and recommendations. Required Certifications & Licensure: Valid Registered Nurse license in the State of California. Current American Heart Association Healthcare Provider Basic Life Support (BLS) card.

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