Travel Nurse RN - Case Manager - in Hanover, MD

Position: Travel Nurse RN - Case Manager - $2,125 per week in Hanover, MD
Location: Hanover

Registered Nurse (RN) | Case Manager

Location:

Hanover, MD

Agency:  Cynet Health

Pay:  $2,125 per week

Shift Information:  Days - 5 days x 8 hours

Contract Duration:  13 Weeks

Start Date:

3/30/2026

About the Position

Job Title:

Utilization Review Nurse
Profession:
Registered Nurse
Specialty:
Utilization Management
Duration: 13 weeks

Shift: Day
Hours per

Shift: 8:00 AM - 4:30 PM

Experience:

Minimum of 5 years RN experience
License:
Active RN License

Certifications:

Current experience in Utilization Review

Must-Have:
Current experience with EPIC and referral platforms such as Navi Health or AllScripts.
Proficiency in using Inter Qual and/or Milliman criteria software systems.
Managed care experience in utilization review for at least 1 year preferred.

Description:

The Utilization Review Nurse is responsible for the day-to-day management of health plan members in acute care and rehabilitative facilities.
The Utilization Review Nurse actively monitors the appropriateness of care received by plan members in various settings, including acute hospitals and acute rehabilitation facilities.
The Utilization Review Nurse applies member benefit and medical criteria to determine authorization of services in coordination with medical directors.
The Utilization Review Nurse proactively initiates discharge planning for members, including identification of post-discharge needs and coordination of post-discharge referrals/services.
The Utilization Review Nurse communicates verbally and in writing authorization and/or denial of covered services with providers, facilities, and members.
The Utilization Review Nurse is a member of administrative and clinical teams in their area of assignment.
Clinical knowledge is maintained and updated, and the Utilization Review Nurse must maintain acceptable documentation and quality standards.

Skills:

Excellent verbal and written communication skills to effectively interact with enrollees, physicians, facility staff, and management staff.
Excellent interpersonal skills and attitude to effectively project a positive image of the Managed Care Program.
Strong computer skills and experience with various applications and online systems.
Knowledge of utilizing various criteria sets, such as Inter Qual.
Ability to negotiate and resolve conflicts with external customers.

Requirements
Required for Onboarding   ACLS
BLS
Pharmacology
Skills Checklist
Specialty Exam