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Nurse Specialist

2 months ago

Palm Springs, California, United States Trusted Resource Associates (TRA) Full time

Job Summary:

Trusted Resource Associates (TRA) is seeking a skilled Nurse Specialist to join our team as a Utilization Review Case Manager. As a key member of our team, you will play a vital role in facilitating care along a continuum, ensuring patients receive optimal health, access to care, and appropriate utilization of resources.

Responsibilities:

  • Manage medical necessity processes for accurate and timely payment for services, requiring negotiation with payers on a case-by-case basis.
  • Coordinate care across the continuum, ensuring seamless transitions and optimal patient outcomes.
  • Develop and implement effective resource coordination strategies to meet patient needs.
  • Collaborate with healthcare professionals to ensure accurate and timely payment for services.

Requirements:

  • Current California RN license.
  • At least 2 years of acute care experience and 1 year of Case Management experience in an Acute Care Discharge environment.
  • Strong communication and negotiation skills.
  • Ability to work independently and as part of a team.

Benefits:

  • Guaranteed hours for Travel Contracts.
  • Preferred Booking Agreement for Local Contracts.
  • Weekly Pay.
  • Holiday Pay.
  • Contract Security compared to a contract with an outside agency.