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 and compassionate Registered Nurse (RN) with expertise in Utilization Management (UM) seeking an exciting travel healthcare assignment? TLC Nursing is currently offering a rewarding opportunity at Jersey Shore, Pennsylvania, where you can make a meaningful impact while experiencing the beauty of the East Coast.
In this role, you will utilize your specialized skills in UM to assess, plan, implement, coordinate, monitor, and evaluate healthcare services for patients. Your responsibilities will include collaborating with healthcare providers to ensure appropriate utilization of medical services, reviewing medical records, conducting assessments, and developing care plans to optimize patient outcomes.
This 4-week assignment guarantees 40.0 hours per week, allowing you to focus on delivering high-quality care while exploring the charming Jersey Shore area. With a competitive weekly pay of $2,196.00 and a range of benefits, including Best in the Industry Pay Packages, you can advance your career while enjoying financial stability.
At TLC Nursing, we prioritize our staff's well-being and development. From a $25,000 Life Insurance Policy effective from day one to comprehensive medical, dental, and vision insurance available starting the 1st of the month after hire, we ensure you have the support you need to thrive. Additionally, you can take advantage of Paid Time Off, a 401(k) plan available after one year of employment, and an Employee Assistance Program for free, confidential services.
Join a team that values you as an individual! TLC Nursing, founded by nurses, offers 24/7 recruiter support, personalized career guidance, and assistance with housing and licensing. We are dedicated to empowering you to succeed in your career and personal life.
If you are ready to take the next step in your nursing career and embark on a fulfilling travel healthcare assignment in Jersey Shore, Pennsylvania, apply now to seize this incredible opportunity with TLC Nursing.