Registered Nurse (RN) – Utilization Review/Case Management

Facility

Johns Hopkins HealthCare


Location

Glen Burnie, MD


Contract Terms

Registered Nurse (RN) – Utilization Review/Case Management
Johns Hopkins HealthCare

Currently seeking an NICU Case Management RN to work a 13 week contract (with possible extension) in Glen Burnie, MD.  The ideal candidate will have at least 2 years of clinical experience 1 years in desired specialty. Required skills: RN licensure, Utilization Management

Precertification experience and experience with review criteria such as InterQual are a MUST!

Index and process incoming virtual faxes and organizing faxes in prescribed form with 100% accuracy.

Microsoft application proficient skills.

Description of Duties: The Medical Review (URN) is responsible for proecessing authorization requests in accordance to members’ evidence of coverage (EOC), established medical criteria for medical necessity and renders a determination within his/her scope of practice.  The URN collaborates with requesting providers and UM Medical Directors in obtaining additonal information that may support the request for an authorization.  The URN appplies medical criteria and medical policies in accordance to company policy, documents in aqccordance to company policy and guidelines within the established timeframes based on prodcut (line of business jurisdiction and request priority.  The medical review URN prepares the adverse determination letter content in accordance to established company policy, guidelines and timeframes.

Looking for RN with previous utilization reveiw experience.

Experience with Interqual and/or Miliman a plus.

Shift – Mon-Fri Days 8:30a-5p
Starting ASAP
Long-term full time (13 weeks to start with possible extension)
For immediate consideration, please send your resume via email to contracts@cms24-7.com


Shift Time

Days


Weekend/Holiday

No weekends/No holidays


Float

N/A


Pay Rate

$35 / Hour


Skill Set Requirements

Must have at least 2 years of Clinical Experience and 2 years in desired specialty.
Registered Nurse (RN) – Utilization Review/Case Management


Profile Requirements

Require an updated resume, skills checklist, and two recent manager or supervisory references. Please note these are the standard requirements but they can vary by facility. Need active MD or compact license.


Rate Details

Please note: Quoted pay rate is for local candidates. Travelers will be paid the equivalent of the local rate minus housing. Housing stipends available. Please note orientation is paid at full rate and parking is reimbursed. Travelers please request a sample pay stub to know to see your take home wage.


If you are interested in this position, please complete an electronic application here. We will contact you as soon as possible to discuss this position, as well as all other contract and per diem positions of interest, available with Chesapeake Medical Staffing.

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