RN - Case Management

Utilization Review Nurse

Location: Juneau, Alaska

Assignment Duration: This is a 13-week contract position.

Schedule: Will discuss at interview.

Job Description: The Utilization Review Nurse will manage patient progression of care, promote evidence-based protocols, and ensure appropriate interventions and expedited delivery of care for patients admitted. The role involves conducting reviews of patient records, monitoring hospitalization necessity, and ensuring a timely discharge through collaboration with healthcare teams.

Responsibilities:

• Review patient records and evaluate patient progress.
• Perform continuous review of patient hospitalization to monitor necessity and quality of care.
• Provide Utilization Management (UM) functions to the Purchased/Referred Care Services program.
• Collaborate with providers and leadership to ensure adherence to the UM/CM/DCP plan.
• Develop personalized treatment plans based on patient conditions and needs.
• Communicate effectively with claims adjusters and maintain utilization review logs.
• Facilitate educational programs and provide quality reviews to support clinical improvements.

Required Experience / Certifications / Licensure:

• Bachelor's Degree in Nursing.
• Active nursing license in Alaska required.
• Case Management certification by a recognized certifying organization preferred.
• 8 years of clinical care or nursing experience, including 3 years in chart review, risk management, or quality service.
• Knowledge of medical record review for medical necessity and insurance reimbursement.

Why ARMStaffing?

• Health Benefits: Medical, Dental, Vision, Life, and more
• Onboarding Made Easy: We handle physicals, titers, and more so you can focus on care
• Clinical Support: In-house clinical team available to assist and advocate
• 401k Retirement Plan: Eligible after waiting period; 4% match with 5% contribution
• Recruiter Matching: Get paired with a recruiter based on your location and specialty
• Extras: Travel reimbursement, housing allowance, meals, referral bonuses, and more

We're not the only ones who think ARMStaffing should be your first choice. Here's why:

• SIA's Top-50 Fastest Growing Healthcare Staffing Firms 2019
• SIA's Largest Healthcare Staffing Agencies in the U.S. 2023
• Top Workplace in the Lehigh Valley 2022, 2023
• Perfect scores for 'Name, Not a Number' and 'Recruiters' Personalities' on Highway Hypodermics
• We've earned The Joint Commission's Gold Seal of Approval for healthcare staffing 15 years strong and counting!

Contract & local rates may vary based on location and applicant residency. Ask your ARMStaffing recruiter for details!

Client Details City Sitka State AK Zip Code 99835