Local Contract Nurse RN - Acute Care - 40-45 per hour - Fresno - Pyramid Consulting (Travel)

    Pyramid Consulting (Travel)
    Pyramid Consulting (Travel) Fresno

    11 hours ago

    Description

    Pyramid Consulting (Travel) is seeking a local contract nurse RN Acute Care for a local contract nursing job in Philadelphia, Pennsylvania.

    Job Description & Requirements


    Specialty:
    Acute Care

    Discipline:
    RN

    Start Date:
    02/23/2026

    Duration:
    13 weeks
    40 hours per week

    Shift:
    8 hours, days

    Employment Type:
    Local Contract


    Title:
    Care Management Coordinator/RN


    Duration:
    13+ weeks

    Work Location Address:
    Remote


    DEPARTMENT:
    Care Management and Coordination

    PA RN license (only) required

    This req will be for our General Precert team- training will be streamlined for PT/OT/ST requests and bariatric requests.


    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.

    Position is remote - candidate must reside in the tri-state area (PA, DE, NJ)

    Must have an active PA license or a Nurse Licensure Compact to include PA.

    This req will be for our General Precert team- training will be streamlined for PT/OT/ST requests and bariatric requests.

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