Job Description
Job Overview
TLC Nursing Associates, Inc. is seeking a skilled and detail-oriented Registered Nurse – Utilization Management (UM) to review healthcare services, ensure clinical appropriateness, and coordinate effective patient care within regulatory guidelines.
Responsibilities
- Review patient medical records, treatment plans, and diagnostic information to assess the necessity and appropriateness of care.
- Collaborate with healthcare providers, insurance companies, and case managers to facilitate approval of services.
- Ensure compliance with clinical guidelines, payer policies, and regulatory standards.
- Analyze utilization data and identify opportunities for care improvement and cost containment.
- Communicate utilization decisions and provide education to providers and patients regarding coverage and care options.
- Document all review activities accurately and maintain patient confidentiality.
- Support quality assurance initiatives related to utilization management processes.
Qualifications
- Current Registered Nurse (RN) license in the state of practice.
- Experience in utilization management, case management, or clinical review preferred.
- Strong clinical assessment, critical thinking, and decision-making skills.
- Knowledge of healthcare regulations, insurance processes, and clinical guidelines.
- Excellent communication, organizational, and interpersonal skills.
- Ability to work independently and as part of a multidisciplinary team.
Benefits
- Competitive pay and flexible contract options.
- Comprehensive medical, dental, and vision insurance plans.
- Opportunities for professional growth and continuing education.
- Supportive work environment with 24/7 access to a dedicated staffing and clinical liaison team.
Job Description
Are you a skilled Registered Nurse (RN) seeking a captivating opportunity in Utilization Management (UM)? Picture yourself immersed in the serene coastal town of Camden, Maine, where your expertise will be valued during an exciting 8-week travel healthcare assignment.
In this role, you will play a pivotal part in optimizing healthcare resources by evaluating medical necessity and ensuring efficient care delivery. Your days will be spent collaborating with interdisciplinary teams, conducting utilization reviews, and developing strategies to enhance patient outcomes within the UM framework.
At $2164.0 weekly pay, this assignment offers not just a career opportunity, but a chance to explore the picturesque landscapes of Camden while making a meaningful impact in healthcare. With 40.0 guaranteed hours, you can rest assured that your dedication will be recognized and compensated accordingly.
Join our team and enjoy exclusive benefits including Best in the Industry Pay Packages, a $25,000 Life Insurance Policy from Day One, and comprehensive Medical, Dental, and Vision Insurance starting the 1st of the month after hire. Additionally, you'll have access to Paid Time Off from day one, eligibility for 401(k) after 1 year, and Aflac options for supplemental coverage. Our Referral Program rewards you for bringing in top talent, while our EAP ensures you and your household receive the support you need.
Embrace a culture of support and growth at TLC Nursing, where our nurse-founded organization provides 24/7 recruiter assistance, personalized career guidance, and aid with housing and licensing. Your success is our priority, and we are here to ensure your journey as a travel nurse is smooth and fulfilling.
Ready to elevate your nursing career in UM while exploring the beauty of Camden, Maine? Apply now and take the first step towards a rewarding travel healthcare assignment with TLC Nursing.
Job Tags
Weekly pay, Contract work, Flexible hours