Travel Nurse RN - Care Manager
Burlington, NC
Care Career
5x8 hrs, Days
Referral Bonus

Case Manager – Utilization Review

Location: Cone Health, North Carolina
Shift: Monday–Friday, 7:00 AM–3:30 PM
Schedule: 5x8-hour shifts
Contract: 13 weeks
 

Job Overview

Cone Health is seeking an experienced Case Manager – Utilization Review to support inpatient and acute-care patient populations. This position is responsible for coordinating patient care, completing utilization review, assessing patient needs, supporting discharge planning, and promoting appropriate, cost-effective healthcare outcomes.

The ideal candidate will have strong acute hospital experience, prior charge nurse experience, extensive case management and utilization review knowledge, and proficiency with Epic.
 

First-time travelers are not accepted.
 

Required Qualifications

• Minimum 2 years of nursing experience.
• Previous travel nursing experience required; no first-time travelers.
• Current active RN license must be in hand at submission.
• Current BLS certification required.
• Acute hospital experience required.
• Previous Charge RN experience required/preferred.
• Epic experience required.
• Case Management and Utilization Review experience required.
• Experience with discharge planning and needs assessment required.
• Experience ordering DME and developing plans of care required.
• Experience with CMS/regulatory requirements required.
• Current driver's license required for address verification.
• No open background-check cases permitted.

Required Clinical Experience

Candidates should have experience with one or more of the following acute-care specialties:

• ICU
• Medical-Surgical (MS)
• PICU
• SDU/PCU/IMC
• Observation
• Emergency Department
• Surgical Services
• Women's Services

Key Responsibilities

• Assess patient needs and develop individualized plans of care.
• Coordinate multidisciplinary patient care throughout the hospital stay.
• Perform utilization review and evaluate medical necessity.
• Review patient status, treatment plans, and level-of-care requirements.
• Coordinate discharge planning and facilitate safe transitions of care.
• Conduct comprehensive needs assessments.
• Arrange appropriate post-acute services and equipment.
• Order and coordinate DME when clinically appropriate.
• Coordinate referrals and follow-up services.
• Monitor patient progress and revise care plans as needed.
• Promote appropriate utilization of healthcare resources.
• Apply CMS and other applicable regulatory requirements.
• Collaborate with physicians, nursing staff, social workers, therapists, and other interdisciplinary team members.
• Advocate for patients while supporting quality, safety, and cost-effective care.
• Maintain accurate and timely documentation in Epic.
• Support positive patient outcomes and patient satisfaction.

Core Skills

• Case Management
• Utilization Review
• Acute Hospital Nursing
• Care Coordination
• Discharge Planning
• Needs Assessment
• DME Coordination
• Plan of Care Development
• CMS/Regulatory Compliance
• Epic
• Clinical Documentation
• Interdisciplinary Collaboration
• Patient Advocacy
• ICU
• Medical-Surgical
• PICU
• SDU/PCU/IMC
• Observation
• Surgical Services
• Women's Services

Travel & Compliance Requirements

• No local candidates within 50 miles of the facility.
• Traveler's RTO must be submitted with the initial application; post-submission RTO will not be accepted.
• Third-party education verification is required.
• Degrees from schools appearing on the Florida Diploma Fraud Audit list will not be accepted.
• Active license must be in hand at submission.
• Travelers may be floated to any Cone Health campus as needed.
• All RNs must successfully complete a compliance EKG examination; up to two attempts are allowed.
• Required modules are non-billable and average 2–4 hours.
• Modules are completed during orientation and are not included in NBO.
• Module hours vary by unit.

Vaccination Requirements

• COVID-19 vaccination required, with medical or religious exemptions only.
• Flu vaccination required, with medical or religious exemptions only.

Position Details

Shift: Days, 7:00 AM–3:30 PM
Schedule: Monday–Friday, 5x8s
Weekend/Holiday: Some weekends may be required based on staffing; holidays as needed
Contract Length: 13 weeks
Charting System: Epic
Certifications: BLS
Travel Experience: Required
Position Type: Case Management / Utilization Review RN