Registered Nurse - Case Management

Job Description

Job Description

Registered Nurse - Case Management
Plymouth, MA
06/29/26 to 09/26/26
13 Weeks
40 Hours/week
8H Day 07:30 AM - 04:00 PM

Description:
8H day shift, rotating weekends.
Required: MA license, BLS-AHA
3-5 years experience in setting, Preferred: ACM, CCM or CMAC

Duties/Responsibilities:

• Reviews admission data to establish the appropriate level of care using Interqual criteria.
• Integrates clinical knowledge with billing knowledge to review, evaluate, and appeal clinical denials related to the care provided to the hospitalized patient.
• Conducts concurrent reviews to determine the continued need for acute care setting, appropriateness and timeliness of treatments/procedures and to optimize the potential for reimbursement.
• Collaborates with the multidisciplinary team to assess and improve the denial management, documentation, and appeals process.
• Collaborates with UR Manager and/or physician advisor regarding cases that do not meet established guidelines for admission or continued stay.
• Acts as a liaison between physicians and payers, coordinating peer-to-peer phone calls.
• Collects and compiles data as required.

NO local travelers will be accepted (cannot reside within 50 mi from the facility) Start date: ASAP, biweekly starts NM to interview and offer-- Please provide dates and times available for interview at time of submission ALL RTO REQUESTS MUST BE PRESENTED AT TIME OF SUB Travelers who have worked for Beth Israel Lahey Health as travel, perm or per diem within the last year will not be accepted - MUST be separated from facility for one year to be considered
#TB_RN
#ZRHC

#CASE1

Why TalentBurst?
At TalentBurst, we deliver more than talent, we deliver outcomes. We partner with you to move quickly and connect you to opportunities aligned with your skills and long term growth.

Backed by precision, transparency, and results, we connect top talent with leading organizations through trusted partnerships.

We offer competitive compensation and comprehensive benefits, including medical, dental, vision, and retirement options.

TalentBurst is an equal opportunity employer committed to an inclusive and diverse workforce.

Company Description

Founded in 2002 by three former Monster.com executives; TalentBurst is an award-winning full-service Staffing Firm working directly with Fortune 500 companies in the US and Canada. We specialize in Contract and Contract to Permanent roles across many industries and have direct/contractual relationships with all our clients. Please visit our website or come meet us at our offices in Natick, MA, Miami, FL, Christiansburg, VA, Vineland, NJ, Houston, TX & downtown San Francisco, CA

Company Description

Founded in 2002 by three former Monster.com executives; TalentBurst is an award-winning full-service Staffing Firm working directly with Fortune 500 companies in the US and Canada. We specialize in Contract and Contract to Permanent roles across many industries and have direct/contractual relationships with all our clients. Please visit our website or come meet us at our offices in Natick, MA, Miami, FL, Christiansburg, VA, Vineland, NJ, Houston, TX & downtown San Francisco, CA