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) with a passion for Utilization Management (UM)? A thrilling 12-week travel healthcare assignment awaits you in the vibrant city of Lanham, Maryland.
As a dedicated RN specializing in UM, you will play a pivotal role in optimizing healthcare resources and ensuring quality patient care. Your responsibilities will include conducting utilization reviews, collaborating with healthcare teams to streamline processes, and implementing cost-effective healthcare solutions.
Join our team and enjoy the Best in the Industry Pay Package, including a weekly pay of $2394.44. In addition, you'll receive a comprehensive benefits package, starting with a $25,000 Life Insurance Policy effective from day one. Medical, Dental, and Vision Insurance will be available starting the 1st of the month after hire, along with Paid Time Off that accrues from day one and becomes eligible after 1 year of employment. Our 401(k) plan becomes available after 1 year of employment and is fully vested after 5 years. You can also benefit from Aflac, a Referral Program, and Employee Assistance Program (EAP) services.
At TLC Nursing, we pride ourselves on our nurse-founded organization that offers 24/7 recruiter support, personalized career guidance, and assistance with housing and licensing. Your success is our priority, and we are here to support you every step of the way.
Don't miss this incredible opportunity to enhance your career in UM as a travel nurse in Lanham, Maryland. Apply now and take the next step towards a rewarding healthcare assignment.
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Job Tags
Weekly pay, Contract work, Flexible hours