Travel Nurse RN - Case Manager - $1,932 per week in Charlestown, MA

Company: TravelNurseSource
Location: Charlestown
Posted on: March 29, 2026

Job Description:

Registered Nurse (RN) | Case Manager Location: Charlestown, MA Agency: Cynet Health Pay: $1,932 per week Shift Information: Days - 5 days x 8 hours Contract Duration: 13 Weeks Start Date: 4/6/2026 About the Position TravelNurseSource is working with Cynet Health to find a qualified Case Manager RN in Charlestown, Massachusetts, 02129! Job Title: Prior Authorization Clinician Profession: Clinical Specialty: Prior Authorization Duration: 13 weeks Shift: 8 hours Hours per Shift: 8 Experience: Minimum of 2 years prior authorization experience and knowledge of evidence-based guidelines. License: Active, unrestricted RN license in state of residence Certifications: None specified Must-Have: Knowledge of Medicare and Medicaid Description: The Prior Authorization Clinician is responsible for reviewing all proposed hospitalization, home care, and inpatient/outpatient services for medical necessity and efficiency. This role ensures members receive appropriate and timely care to support optimal health outcomes. The clinician determines the medical appropriateness of inpatient and outpatient services by evaluating medical guidelines. They apply evidenced-based criteria to make decisions. Utilization review activities include pre-certification, concurrent, and retrospective reviews. The clinician assesses medical necessity by applying the appropriate medical criteria to initial reviews. Decision-making and critical-thinking skills are essential for determining coverage for medically necessary health care services. All utilization review activities and outcomes must be documented and communicated effectively. The clinician refers cases to a Physician Reviewer when requests do not meet medical necessity guidelines. Referrals must be conducted in a timely manner according to departmental policies. Strong interpersonal and communication skills are required for conducting reviews and interactions. The clinician sends appropriate system-generated letters to providers and members. Guidance and coaching for other utilization review nurses are part of the role. The clinician participates in team meetings, educational discussions, and related activities. Compliance with all federal, state, and accreditation organizations is necessary. Opportunities for improved communication or processes should be identified. The clinician may participate in audit activities and meetings. Accurate documentation of rate negotiation is essential for proper claims adjudication. Potential cases may be identified and referred for Care Management. All other related duties may be assigned as necessary. 5 Benefits of Travel Nursing Adapting to new facilities and teams challenges your problem-solving skills. You learn to navigate different protocols and procedures, honing your ability to think critically and adapt to varying healthcare contexts. Constantly adapting to new environments and healthcare facilities challenges you to expand your knowledge and skills. This dynamic nature of travel nursing contributes significantly to your professional growth. Tailor your career path by selecting assignments that align with your professional goals and interests. This customization allows you to focus on areas of healthcare that resonate with your passion. There is a strong community of travel nurses who share experiences, advice, and support through online forums and social media groups, creating a sense of camaraderie and shared purpose. Travel nurses may benefit from tax advantages such as housing stipends and per diems, helping them maximize their income and financial stability. Requirements Required for Onboarding ACLS BLS Pharmacology Skills Checklist Specialty Exam 29578899EXPTEMP

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