Travel Nurse RN - Case Manager - $2,976 per week in Albuquerque, NM

Company: Cynet Health
Location: Albuquerque
Posted on: July 8, 2025

Job Description:

Job Title: RN Profession: Nursing Specialty: Utilization Review/Case Manager Duration: 13 weeks Shift: 0800-1630 Hours per Shift: 8 Experience: Five years in clinical nursing; minimum of two years in emergency or acute clinical utilization review or case management within the last 10 years. License: Required New Mexico RN license Certifications: BLS required; national certification preferred within three years of hire. Must-Have: Computer knowledge including Windows, Word, Excel, and database systems; ability to analyze trends based on decision support systems; business management skills including cost/benefit analysis and negotiation; knowledge in referral coordination to community and private/public resources. Description: Responsible for coordinating patient care across the continuum using assessment, care planning, implementation, coordination, monitoring, and evaluation for cost-effective and quality outcomes in a primarily inpatient setting. Facilitates members' transfer when services are available. Coordinates and facilitates the transfer of patients using established transfer center processes. Once a decision for admission is made, collects clinical information to determine the patient’s level of care. Collaborates with the transfer center to manage the transfer of members. Conducts an in-depth assessment that includes psychosocial, physical, medical, environmental, and financial parameters. Collaborates with the healthcare team to proactively develop, implement, and document treatment and discharge plans, addressing social, physical, mental, emotional, spiritual, and supportive needs. Formulates, implements, coordinates, monitors, and evaluates strategies with the healthcare team to address care management issues for specific patients and disease processes. Applies utilization review criteria to assess and document the appropriateness of admission, continued stay, level of care, and readiness for discharge. Refers cases that do not meet criteria to the designated Physician Advisor. Promotes the appropriate use of clinical and financial resources to improve quality of care and patient/member satisfaction. Performs cost-benefit analyses and engages in negotiations as needed. Generates reports demonstrating efficacy through direct cost savings and outcome measures. Actively participates in the development of clinical guidelines and pathways, incorporating processes into the role of nurse care coordinators. Educates providers and other departments on health management strategies and care coordination services. Receives, reviews, verifies, and processes requests for approval of pre-service and concurrent services, supplies, and procedures. Performs retrospective reviews and conducts audits as necessary, accurately documenting findings. Upon completion, compiles detailed findings and supporting documentation for review. Performs other functions as required.

Keywords: Cynet Health, Albuquerque , Travel Nurse RN - Case Manager - $2,976 per week in Albuquerque, NM, Healthcare , Albuquerque, New Mexico