RN: Case Manager

Job Description

Join an in-person Travel Utilization Review Registered Nurse role in Kinston, North Carolina, supporting utilization management for timely, well-supported care decisions within an acute hospital setting. This position focuses on evaluating the appropriateness of admission, level of care, continued hospitalization, and readiness for care transitions using established criteria. You’ll conduct concurrent review, help identify and resolve care, service, or transition delays, and collaborate with the care team to keep movements through the continuum of care on track.

You’ll also provide third-party payers with the clinical information needed to support reimbursement and partner with physicians on documentation for authorization. If you’ve worked with denials management—including insurance denials, peer-to-peer, and appeals—this assignment is designed for you. Expect to use Inter Qual and MCG evaluation criteria to justify admissions and level of care.

Schedule:

M–F, 8:30 AM–5:00 PM (5x8s). Orientation includes 24 hours.

Location:

100 Airport Road, Kinston, North Carolina 28501, United States

Shift: 8 hour days (5x8s), M–F, 8:30 AM–5:00 PM; no weekends; no call

Duration: 13 weeks