RN - Case Manager

Case Manager and Utilization Review RN

Job Title: Case Manager and Utilization Review RN

Profession: Registered Nurse

Specialty: Case Manager

Duration: 13 weeks

Shift: Day

Hours per Shift: 8 hours

Experience: 5 years required

License: State License required

Certifications: BLS, BSN

Must-Have: Acute Client experience, Long Term Acute Care/Rehab/Skilled Nursing experience, Epic documentation experience, InterQual documentation experience

Description: Case Manager and Utilization Review RN for Cancer Specialty Client. Five years of experience is required. Utilize Epic and InterQual documentation. SBAR communication is essential. Weekends are required. BLS, BSN, and State License are mandatory certifications. Skills and experience required include: Acute Client experience. Understanding of Long Term Acute Care/Rehab/Skilled Nursing. Knowledge of Admission Criteria. Care Coordination expertise. Discharge Planning abilities. Application of InterQual Criteria. Utilization of Milliman Guidelines. Understanding of UR Admission Criteria. Experience with UR Appeals and Denials. UR Concurrent Review experience. UR Continued Stay Reviews knowledge. UR Medical Necessity expertise. UR Retrospective Review experience. Understanding of CMS guidelines. Familiarity with CPT coding and billing. Knowledge of the Department of Health regulations. Understanding of DRG (Diagnosis Related Groups). Familiarity with HEDIS measures. Knowledge of HIPAA guidelines. Experience with ICD 10 coding. Awareness of NCQA standards. Understanding of OSHA regulations. Knowledge of The Joint Commission Core Measure/National Safety Goals. Understanding of Workers Compensation regulations.

We offer competitive benefits, including:

• Medical, dental & vision insurance
• Free and unlimited continuing education units (CEUs)
• 24/7 dedicated Care Line and clinical liaison support
• Personalized career consultant and "single point of contact" service
• Industry‑leading pay rates, loyalty rewards & referral bonuses
• Free tax return assistance for travelers
• 401(k) Retirement Plan
• Health Savings Account (HSA)
• Disability Insurance (Short-Term and Long-Term)
• Life and AD&D Insurance
• Paid Sick Leave (where required by applicable state or local law)
• Supplemental Insurance Plans
• Identity Theft Protection
• Pet Insurance
• Employee Wellness Programs
• Employee Assistance Program (EAP)
• Career Growth and Professional Development Opportunities

Disclaimer: Benefits eligibility, accrual rates, and usage limits may vary based on employment status, length of service, and work location. Paid Sick Leave is provided in strict accordance with applicable state and municipal mandates. Cynet Health reserves the right to modify, amend, or terminate any benefit plans at any time in accordance with applicable laws.

About Cynet Health: Cynet Health is a Joint Commission-accredited, Minority-Owned healthcare staffing agency headquartered in Sterling, Virginia, proudly serving healthcare facilities across the United States since its founding in 2010. As one of the nation's largest and fastest‑growing healthcare staffing firms in the nation, we staff thousands of nursing, allied health, locum tenens, pharmacy, therapy, direct‑hire, and non‑clinical professionals across hospitals, clinics, long‑term care facilities, labs and more. We're one of the most decorated staffing agencies in America-ranked a Top Travel Nursing Company by BluePipes, recognized among the fastest‑growing and most diverse staffing firms by Inc. 5000, Staffing Industry, WBJ and USPAACC-and remain deeply committed to excellence, inclusion, and community impact.

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