Travel ContractRN Case Manager – Utilization Review
$3,282-3,618/week
RN Case Manager – Utilization Review
Bakersfield, California
Kern Medical Center
$3,282-3,618/weekPosted 2 hours ago
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TNAA TotalMed RN3.5rating(78 reviews)
Hourly Rate$83
Stated hours40
Job info
Job Title
RN-Case Management (Utilization Review)
Location
- Bakersfield, California
Employment Type
- Clinical Nursing Travel
Contract Length
- 13 weeks
Work Schedule
- Night shift
- 8 hours per day, 40 hours per week
- Monday to Friday 8:00 AM - 4:30 PM with rotating weekend coverage
Job Summary
Utilization Review Nurse II performs utilization review and discharge planning activities, including evaluating medical records for inpatient admissions, coordinating with physicians and hospital services, ensuring proper documentation for reimbursement, and formulating discharge plans.
Key Responsibilities
- Obtain and evaluate medical records to verify required documentation for admissions
- Initiate Physician Advisories for unwarranted admissions
- Conduct ongoing reviews and discuss care changes with attending physicians
- Formulate and document discharge plans
- Coordinate with hospital services to ensure efficient resource use
- Identify pay source issues and provide intervention for referrals
- Coordinate with admitting office and clinics regarding admissions and specialized tests
- Review and approve surgery schedules to ensure authorization of elective procedures
- Collaborate with correctional facilities on appropriate use of services
- Educate providers on documentation requirements to maximize reimbursement
- Assist in training Utilization Review Nurse I staff as needed
Required Qualifications
Experience & Education
- Valid Registered Nurse license in California
- Associate of Science in Nursing / Associate Degree in Nursing
- Minimum 1 year of Utilization Review experience within the last year
- Case Management experience
- Experience with InterQual Guidelines
- Knowledge of payor source documentation requirements and governmental regulations affecting reimbursement
- Medical record evaluation skills
Licensure & Certifications
- Current American Heart Association Healthcare Provider Basic Life Support (BLS) certification
Facility
Kern Medical Center
3.1rating(32 reviews)
1 nurse recommends working with Kern Medical Center
5.0rating
Anonymous
ED - Emergency Department (RN)
DetailsVerification data is contributed by healthcare professionals like you, who leave reviews on Vivian.
- Short Term Acute Care
- 214 beds
ADDRESS1700 Mount Vernon AvenueBakersfield, CA 93306
View more detailsAbout Bakersfield, CA
As a Travel Nurse Case Manager in Bakersfield, CA here's what you should know:Cost of Living
- Bakersfield's cost of living is lower than the national average, making it an affordable place to live.
- Wages generally match up with the lower cost of living.
Weather
- Summer average highs are around 95°F, and winter average lows are around 39°F.
Furnished Housing
- Short term rentals are easy to find in Bakersfield, with many options available for furnished housing.
Transportation
- Bakersfield is car-friendly, with a majority of residents relying on personal vehicles.
- Public transportation options are available but may be limited compared to larger cities.
Demographics
- Bakersfield has a diverse population with a wide age range.
- Common health issues include respiratory conditions due to air quality concerns.
- There is a growing population of travel nurses in the area.
Things to Do
- Bakersfield offers a variety of restaurants featuring local and international cuisines.
- The city has a vibrant arts and music scene, with opportunities to enjoy live performances.
- Sports enthusiasts can partake in local events and outdoor activities such as hiking and biking.
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