Local Contract Nurse RN - Philadelphia - Pyramid Consulting (Travel)

    Pyramid Consulting (Travel)
    Pyramid Consulting (Travel) Philadelphia

    1 week ago

    Freelance
    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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