Travel Nurse RN - Utilization Review - $2,785 per week

Specialty: Utilization Review | Discipline: RN | Start Date: 08/31/2026 | Duration: 8 weeks | 40 hours per week | Shift: 8 hours, days | Employment Type: Travel

Responsibilities

• Performs inpatient and observation utilization reviews
• Reviews medical necessity using clinical documentation, evidence-based guidelines, and payer requirements
• Collaborates with physicians, revenue cycle, and healthcare teams
• Prepares clinical summaries for payer communications and peer-to-peer reviews
• Participates in audits and quality improvement initiatives

Requirements

• Shift: REMOTE Days | Mon–Fri | 8:00 AM – 4:30 PM
• BSN required
• Active California RN License
• Magnet ANCC-recognized Case Management certification (CCM, ACM-NBCM, etc.)
• Minimum 5 years of clinical nursing experience
• Minimum 3 years of Utilization Review/Case Management experience
• Cerner experience
• Understanding of MCG and Utilization Review requirements for concurrent and initial reviews
• Knowledge of Medicare, Medicaid, managed care, payer, and healthcare financial requirements
• Proficiency in Cerner, Adobe, and Microsoft Office Suite (Excel, Teams, Outlook, PowerPoint, Word)
• Candidate must provide their own equipment for chart reviews

Skills

• Utilization review
• Case management
• Performance improvement
• Managed care reimbursement
• Milliman Care Guidelines (MCG)
• EMR navigation and UR documentation tools

Benefits

• Referral Bonus: $250-$500 per referral
• Medical and other benefits

About Talent4Health

A leader and innovator, offering comprehensive talent solutions for the healthcare industry across the nation. Talent4Health, based in Wilmington, DE, is a one-stop solution that provides access to an inclusive network of excellent healthcare professionals through its state-of-the-art recruitment strategies and extensive career opportunities. We have successfully placed over 3,000 clinicians with top healthcare facilities across 50 states in the U.S.

Why Choose Us?

• Proficiency: Our seasoned team of professionals has years of experience and is dedicated to providing the highest quality service to our clients and candidates.
• Personalized service: We understand that every candidate is unique, and we work closely with each one to develop a customized plan that meets their specific needs.
• Consistency: We are devoted to offering dependable recruitment solutions for our candidates and are always a phone call away for all their questions or concerns.
• Comprehensive care: Our healthcare recruitment team works across different specialties, so there is a job for everyone.