Local Contract Nurse RN - Care Manager - 40-45 per hour - Phila - Pyramid Consulting (Travel)

    Pyramid Consulting (Travel)
    Pyramid Consulting (Travel) Phila

    1 week ago

    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:
    02/23/2026

    Duration:
    26 weeks
    18.75 hours per week

    Shift:
    10 hours, days

    Employment Type:
    Local Contract

    Title:
    Care Management Coordinator/RN


    Duration:
    6 Months Contract (Temp to hire)

    Work Location Address:
    Remote


    DEPARTMENT:
    Care Management and Coordination

    PA RN license (only) required


    Education:
    Active PA Licensed RN required
    BSN Preferred
    Experience
    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.

    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.

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