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Local Contract Nurse RN - Acute Care Case Management - $40-45 per hour
- [job_card.temporary]
Pyramid Consulting (Travel) is seeking a local contract nurse RN Acute Care Case Management for a local contract nursing job in Philadelphia, Pennsylvania.
Job Description & Requirements
- Specialty : Acute Care Case Management
- Discipline : RN
- Start Date : 01 / 12 / 2026
- Duration : 12 weeks
- 40 hours per week
- Shift : 8 hours, days
- Employment Type : Local Contract
Title : Care Management Coordinator / RN
Location : 100% Remote
Duration : 03 months contract (Temp to Hire)
PR Range : $45.00 / hr. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).
Position is remote - candidate must reside in the tri-state area (PA, DE, NJ)
Must have an active PA license or a Nurse Licensure Compact to include PA.
Job Description
JOB TITLE : Care Management Coordinator
Would work on Infusion Therapy Team
DEPARTMENT : Care Management and Coordination
Job Summary
The Care Management Coordinator primary responsibility is to evaluate a member’s clinical condition through the review of medical records (including medical history and treatment records) to determine the medical necessity for patient’s services based on advanced knowledge and independent analysis of those medical records and application of appropriate medical necessity criteria. If necessary, the Care Management Coordinator directly interacts with providers to obtain additional clinical information. The Care Management Coordinator has the authority to commit the company financially by independently authorizing services determined to be medically necessary based on their personal review. For those cases that do not meet established criteria, the Care Management Coordinator provides relevant information regarding members medical condition to the Medical Director for their further review and evaluation. The Care Management Coordinator has the authority to approve but cannot deny the care for patients. The Care Management Coordinator is also responsible for maintaining regulatory compliance with federal, state and accreditation regulations. Additionally, the Care Management Coordinator acts a patient advocate and a resource for members when accessing and navigating the health care system.
Key Responsibilities
Note : InterQual - It is the policy of the Medical Affairs Utilization Management (UM) Department to use InterQual (IQ) criteria for the case review process when required. IQ criteria are objective clinical statements that assist in determining the medical appropriateness of a proposed intervention which is a combination of evidence-based standards of care, current practices, and consensus from licensed specialists and / or primary care physicians. IQ criteria are used as a screening tool to support a clinical rationale for decision making.
3 yrs experience as an RN
Experience completing medical necessity reviews
RN with infusion experience working in a chemo office or infusion agency - hospital experience is not the right fit for this role
Clinical experience
Critical thinker
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