RN - Case Management

Philadelphia, PA 19103

Posted: 06/21/2024 Employment Type: Local Profession: RN Job Number: 89393 Pay Rate: $1,392 - $1,547 Specialty: Case Management

Job Description

Are you a detail-oriented RN with a knack for navigating complex medical cases? Do you thrive on making critical decisions that impact patient care? Join us as a Care Management Coordinator and play a key role in evaluating and authorizing essential healthcare services.

 

Shift: Monday – Friday (8am – 5pm Normal business hours)

Type: Temp to Hire (Candidates will be remote but need to reside in the tri-state area.)

Pay Rate: 37.50 -40.00 Hourly (paid weekly)

 

What You’ll Do:

  • Clinical Analysis: Review medical records to determine the necessity of patient services based on advanced criteria.
  • Provider Interaction: Collaborate with healthcare providers to clarify and obtain additional clinical information.
  • Decision-Making: Authorize medically necessary services and refer cases that don’t meet criteria to the Medical Director.
  • Compliance & Advocacy: Ensure adherence to regulatory standards and act as a resource for members navigating the healthcare system.
  • Data Management: Maintain accurate records and report trends or issues to improve care quality.

Qualifications:

  • Licensure: Active PA RN license required; BSN preferred.
  • Experience: Minimum of 3 years in acute care with a preference for utilization management or medical management experience.
  • Skills: Exceptional communication, problem-solving, and organizational skills. Proficient in Microsoft Office Suite and adaptable to new technologies.
  • Candidates will be remote but need to reside in the tri-state area.

Need to know:

UM RN - PA License. **No LPN candidates.

Utilization RN who handles hospital reviews. Insurance carrier or consultant background would be a bonus.

NOT home care.

Every other weekend needed to work.

 

Ready to make a difference? Apply now and join a dedicated team focused on high-quality patient care!

Benefits & Perks:

  • Weekly direct deposit.
  • Health, dental, and vision insurance.
  • 401(k) with company matching.
  • Paid liability & workers’ comp coverage.
  • Flexible scheduling options.
  • Referral bonuses.
  • Personalized 1:1 career support before, during, & and after assignments.

About Us:

With over 30 years of healthcare staffing experience, GHR Healthcare is your trusted partner in finding the perfect contract or permanent role in the healthcare industry. Our specialized teams have placed thousands of healthcare professionals nationwide. You will have a dedicated recruiter, providing access to new opportunities and guidance every step of the way. Whatever your career goals, GHR Healthcare is here to support you and find your perfect fit. Get to know us: www.ghrhealthcare.com

We are an equal-opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

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