Talent.com
Local Contract Nurse RN - Care Manager - $40-45 per hour
Local Contract Nurse RN - Care Manager - $40-45 per hourPyramid Consulting (Travel) • Philadelphia, PA, US
Local Contract Nurse RN - Care Manager - $40-45 per hour

Local Contract Nurse RN - Care Manager - $40-45 per hour

Pyramid Consulting (Travel) • Philadelphia, PA, US
[job_card.variable_days_ago]
[job_preview.job_type]
  • [job_card.full_time]
[job_card.job_description]

Pyramid Consulting (Travel) is seeking a local contract nurse RN Care Manager for a local contract nursing job in Philadelphia, Pennsylvania.

Job Description & Requirements

  • Specialty : Care Manager
  • Discipline : RN
  • Start Date : 12 / 22 / 2025
  • Duration : 13 weeks
  • 40 hours per week
  • Shift : 8 hours, days
  • Employment Type : Local Contract

Job Title : Care Management Coordinator / RN

Location : Philadelphia, PA (Remote but looking for someone from the tri-state area NJ, PA or DE)

Shift : Days

Duration : 13 Weeks

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 interact 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 :

  • Applies critical thinking and judgement skills based on advanced medical knowledge to cases utilizing specified resources and guidelines to make case determination. Utilizes resources such as; InterQual, Care Management Policy, Medical Policy and Electronic Desk References to determine the medical appropriateness of the proposed plan.
  • Utilizes the medical criteria of InterQual and / or Medical Policy to establish the need for inpatient, continued stay and length of stay, procedures and ancillary services.
  • 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.
  • Contacts servicing providers regarding treatment plans / plan of care and clarifies medical need for services.
  • Reviews treatment plans / plan of care with provider for requested services / procedures, inpatient admissions or continued stay, clarifying medical information with provider if needed.
  • Identifies and refers cases in which the plan of care / services are not meeting established criteria to the Medical Director for further evaluation determination.
  • Performs early identification of members to evaluate discharge planning needs.
  • Collaborates with case management staff or physician to determine alternative setting at times and provide support to facilitate discharge to the most appropriate setting.
  • Reports potential utilization issues or trends to designated manager and recommendations for improvement.
  • Appropriately refers cases to the Quality Management Department and / or Care Management and Coordination Manager when indicated to include delays in care.
  • Appropriately refers cases to Case and Disease Management.
  • Ensures request is covered within the member's benefit plan.
  • Ensures utilization decisions are compliant with state, federal and accreditation regulations.
  • Meets or exceeds regulatory turnaround time and departmental productivity goals when processing referral / authorization requests.
  • Ensures that all key functions are documented via Care Management and Coordination Policy.
  • Maintains the integrity of the system information by timely, accurate data entry.
  • Performs additional duties assigned.

    • Qualifications :

  • Active PA Licensed RN or LPN required
  • BSN Preferred
  • Minimum of three (3) years of acute care clinical experience in a hospital or other health care setting. Prior discharge planning and / or utilization management experience is desirable.
  • Medical management / precertification experience preferred.

    • Knowledge, & Skills :

  • Exceptional communication, problem solving, and interpersonal skills.
  • Action oriented with strong ability to set priorities and obtain results.
  • Team Player - builds team spirit and interdepartmental rapport, using effective problem solving and motivational strategy.
  • Open to change, comfortable with new ideas and methods; creates and acts on new opportunities; is flexible and adaptable.
  • Embrace the diversity of our workforce and show respect for our colleagues internally and externally.
  • Excellent organizational planning and prioritizing skills.
  • Ability to effectively utilize time management.
  • Oriented in current trends of medical practice.
  • Proficiency utilizing Microsoft Word, Outlook, Excel, SharePoint, and Adobe programs. Ability to learn new systems as technology advances
    • [job_alerts.create_a_job]

    Nurse Rn Care Manager • Philadelphia, PA, US

    [internal_linking.related_jobs]
    Local Contract RN - Long Term Acute Care - $48 per hour

    Local Contract RN - Long Term Acute Care - $48 per hour

    Supplemental Health Care • Willingboro, NJ, United States
    [job_card.full_time] +1
    Supplemental Health Care is seeking a local contract nurse RN Long Term Acute Care for a local contract nursing job in Willingboro, New Jersey. Job Description & Requirements Specialty : Long Term Ac...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Local Contract Nurse RN - Telemetry - $53 per hour

    Local Contract Nurse RN - Telemetry - $53 per hour

    ARMStaffing • Voorhees, NJ, United States
    [job_card.full_time]
    Local Contract Nurse RN - Telemetry - $53 per hour at ARMStaffing summary : .The position is for a local contract Registered Nurse specializing in telemetry at a medical facility in Voorhees, NJ, wor...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Local Contract ICU Registered Nurse - $52 per hour

    Local Contract ICU Registered Nurse - $52 per hour

    Stability Healthcare • Philadelphia, PA, United States
    [job_card.full_time]
    Stability Healthcare is seeking a local contract nurse RN ICU - Intensive Care Unit for a local contract nursing job in Philadelphia, Pennsylvania. Job Description & Requirements.Stability Healthcar...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Local Contract Nurse RN - Pain Management - $54 per hour

    Local Contract Nurse RN - Pain Management - $54 per hour

    Ethos Medical Staffing • Philadelphia, PA, United States
    [job_card.full_time]
    Ethos Medical Staffing is seeking a local contract nurse RN Pain Management for a local contract nursing job in Philadelphia, Pennsylvania. Job Description & Requirements.Local Contract Pain Managem...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Local Contract Nurse RN - Care Manager - $50-58 per hour

    Local Contract Nurse RN - Care Manager - $50-58 per hour

    GHR Healthcare • Philadelphia, PA, USA
    [job_card.full_time]
    Local Contract Nurse RN - Care Manager - $50-58 per hour at GHR Healthcare summary : .GHR Healthcare is hiring a Local Contract Nurse RN Care Manager in Philadelphia, Pennsylvania, for a 13-week assi...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Local Contract Nurse RN - Outpatient Care

    Local Contract Nurse RN - Outpatient Care

    WCS Healthcare Partners • Elkins Park, PA, United States
    [job_card.full_time]
    WCS Healthcare Partners is seeking a local contract nurse RN Outpatient Ambulatory Care for a local contract nursing job in Philadelphia, Pennsylvania. Job Description & Requirements Specialty : Ambu...[show_more]
    [last_updated.last_updated_variable_hours] • [promoted] • [new]
    Local Contract ICU Registered Nurse - $52-61 per hour

    Local Contract ICU Registered Nurse - $52-61 per hour

    Medical Solutions • Philadelphia, PA, United States
    [job_card.full_time]
    Medical Solutions is seeking a local contract nurse RN ICU - Intensive Care Unit for a local contract nursing job in Philadelphia, Pennsylvania. Job Description & Requirements.We’re seeking talented...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Local Contract Nurse RN - Care Manager - $40-45 per hour

    Local Contract Nurse RN - Care Manager - $40-45 per hour

    Pyramid Consulting • Philadelphia, PA, United States
    [job_card.full_time]
    Pyramid Consulting is seeking a local contract nurse RN Care Manager for a local contract nursing job in Philadelphia, Pennsylvania. Job Description & Requirements.Job Title : Care Management Coordin...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Local Contract Nurse RN - CVOR - $75 per hour

    Local Contract Nurse RN - CVOR - $75 per hour

    GHR Healthcare - Travel Division • Camden, NJ, USA
    [job_card.full_time]
    Local Contract Nurse RN - CVOR - $75 per hour at GHR Healthcare - Travel Division summary : .GHR Healthcare is seeking a local contract RN specializing in CVOR for a nursing position in Camden, New J...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Local Contract Nurse RN - Med Surg - $52 per hour

    Local Contract Nurse RN - Med Surg - $52 per hour

    TalentBurst, Inc • Philadelphia, PA, United States
    [job_card.full_time]
    TalentBurst, Inc is seeking a local contract nurse RN Med Surg for a local contract nursing job in Philadelphia, Pennsylvania. Job Description & Requirements.Length of assignment : 14 Weeks .Under th...[show_more]
    [last_updated.last_updated_1_day] • [promoted]
    Local Contract Nurse RN - Ambulatory Care - $40 per hour

    Local Contract Nurse RN - Ambulatory Care - $40 per hour

    TalentBurst, Inc • Philadelphia, PA, USA
    [job_card.full_time]
    TalentBurst, Inc is seeking a local contract nurse RN Ambulatory Care for a local contract nursing job in Philadelphia, Pennsylvania. Job Description & Requirements.Schwenksville, PA 19473 / Collegev...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Local Contract Nurse RN - Care Manager - $40-45 per hour

    Local Contract Nurse RN - Care Manager - $40-45 per hour

    Pyramid Consulting (Travel) • Philadelphia, PA, United States
    [job_card.full_time]
    Pyramid Consulting (Travel) is seeking a local contract nurse RN Care Manager for a local contract nursing job in Philadelphia, Pennsylvania. Job Description & Requirements.Job Title : Care Managemen...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Local Contract Nurse RN - Ambulatory Care

    Local Contract Nurse RN - Ambulatory Care

    GHR Healthcare • Elkins Park, PA, United States
    [job_card.full_time]
    GHR Healthcare is seeking a local contract nurse RN Ambulatory Care for a local contract nursing job in Philadelphia, Pennsylvania. Job Description & Requirements Specialty : Ambulatory Care Discipli...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Local Contract Nurse RN - PCU - Progressive Care Unit - $47-48 per hour

    Local Contract Nurse RN - PCU - Progressive Care Unit - $47-48 per hour

    GHR Healthcare - Travel Division • Philadelphia, PA, USA
    [job_card.full_time]
    Local Contract Nurse RN - PCU - Progressive Care Unit - $47-48 per hour at GHR Healthcare - Travel Division summary : .GHR Healthcare is seeking a Local Contract Nurse RN specializing in the Progress...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Local Contract Nurse RN - ICU - Intensive Care Unit - $58 per hour

    Local Contract Nurse RN - ICU - Intensive Care Unit - $58 per hour

    Stability Healthcare • Philadelphia, PA, United States
    [job_card.full_time]
    Stability Healthcare is seeking a local contract nurse RN ICU - Intensive Care Unit for a local contract nursing job in Philadelphia, Pennsylvania. Job Description & Requirements.Stability Healthcar...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Local Contract CCU Registered Nurse - $51 per hour

    Local Contract CCU Registered Nurse - $51 per hour

    Stability Healthcare • Philadelphia, PA, United States
    [job_card.full_time]
    Stability Healthcare is seeking a local contract nurse RN CCU - Coronary Care for a local contract nursing job in Philadelphia, Pennsylvania. Job Description & Requirements.Stability Healthcare is l...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Local Contract Nurse RN - Long Term Acute Care - $47-51 per hour

    Local Contract Nurse RN - Long Term Acute Care - $47-51 per hour

    Host Healthcare • Burlington, NJ, United States
    [job_card.full_time]
    Host Healthcare is seeking a local contract nurse RN Long Term Acute Care for a local contract nursing job in Burlington, New Jersey. Job Description & Requirements.Host Healthcare Job ID #La1fVJ000...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Local Contract Nurse RN - Home Health - $55-60 per hour

    Local Contract Nurse RN - Home Health - $55-60 per hour

    Custom Healthcare Solutions • Cherry Hill, NJ, USA
    [job_card.full_time]
    Custom Healthcare Solutions is seeking a local contract nurse RN Home Health for a local contract nursing job in Cherry Hill, New Jersey. Job Description & Requirements.M-F 8 : 30am - 5 : 00pm Home Heal...[show_more]
    [last_updated.last_updated_30] • [promoted]