Travel Nurse RN - Care Manager
Sitka, AK
Sawgrass Healthcare (A Datson360 Company)
4x10 hrs, Days, Evenings, Nights
Relocation Bonus

Position Overview:
Seeking an experienced RN in Utilization Review / Case Management to manage patient care progression, ensure evidence-based practices, and support efficient, cost-effective healthcare delivery.

Key Responsibilities:

• Review patient records for medical necessity, level of care & length of stay
• Monitor quality of care and hospitalization appropriateness
• Collaborate with physicians, leadership, and interdisciplinary teams
• Support Utilization Management (UM), Case Management (CM), and Discharge Planning (DCP)
• Communicate with payers, regulatory bodies, and claims adjusters
• Handle appeals, denials, and documentation compliance
• Facilitate patient discharge planning and care coordination
• Participate in quality improvement and tumor registry functions

 Requirements:

•  Bachelor’s Degree in Nursing (Required)
• Case Management Certification (Preferred – CCMC/NCQA)
• 8+ years of clinical/nursing experience
• 3+ years in chart review, risk management, or quality services

Skills & Knowledge:

• Strong understanding of medical necessity review & reimbursement guidelines
• Knowledge of ICD-9 / CPT coding & CMS regulations
• Excellent communication, documentation & organizational skills
• Ability to collaborate across teams and manage complex cases