Case Management

Opportunity:

RN - Case Management

Job Details:

• Monday through Friday schedule with no weekend or on-call requirements
• Float within facility and scope of practice as needed
• Minimum 3 years of experience required - first time travelers not accepted
• Travel experience required
• Community hospital experience preferred
• Assess, evaluate, and drive discharge planning for patients
• Coordinate services to ensure patients receive appropriate level of care
• Initiate, evaluate, and re-evaluate treatment plans daily
• Monitor length of stay and identify barriers to discharge
• Follow Medicare regulatory guidelines regarding patient choice, IMM notices, and MOONS
• Conduct concurrent reviews, continued stay reviews, and retrospective reviews
• Utilize InterQual Criteria and Milliman Guidelines
• Apply knowledge of medical necessity, DRG coding, ICD-10 coding, and CPT coding
• Work with adult and geriatric patient populations with a daily census of 20-25 patients
• Experience with appeals and denials, care coordination, and discharge planning required
• Knowledge of CMS, HIPAA guidelines, NCQA, OSHA, and Joint Commission/Core Measures required
• Charting system experience required
• Maximum of 7 days pre-approved time off per contract - all RTO must be finalized at time of submission
• No RTO can be requested during orientation week
• If one or two major holidays fall during assignment, traveler is expected to work all of them; if three major holidays fall during assignment, traveler is expected to work two
• Required certifications: BLS