Travel Nurse (RN) - Case Management

Pre-employment modules may be required for this role. Please upload any certifications or health documents you have to your profile to expedite your on-boarding process.

Additional Details:

Required Skills/Experience: 2- 3 years of directly related RN experience. Must have inpatient CM experience, Community Hospital Experience

Skills: Acute Hospital, MS, SDU/PCU/IMC/Obs, Admission Criteria, Benefits Eligibility, Care coordination, Concurrent Review, Continued Stay Reviews, Data Abstraction, Determine Medical Necessity per Evidence-Based Guidelines, Discharge Planning, Disease management, Needs Assessment/ Order DME, Plan of Care, Utilize InterQual Criteria, Utilize Milliman Guidelines, Utilization Review, Medical Necessity, CMS: Centers for Medicare and Medicaid Services, DRG (Diagnosis Related Groups), HIPAA guidelines (Health Insurance Portability and Accountability Act).

Preferred Skills/Experience: Teaching Hospital Experience, LTAC Experience, Trauma Level I Experience

Skills: Ambulatory, Behavioral Health, Home Health, Hospice, Insurance Company, Long Term Acute Care/Rehab/Skilled Nursing, Telephonic, Emergency Department, ICU, NICU, Surgical Services, Women’s Services, Appeals and Denials, Audits, Disability case management, Pre-Cert Review, Prior Authorizations, Retrospective Review, Worker’s comp case management, CPT (Current Procedural Terminology) coding and billing, Quality Improvement, Department of Health, HEDIS (The Healthcare Effectiveness Data and Information Set) Measures, ICD 10 Coding, NCQA (National Committee for Quality Assurance), OSHA, The Joint Commission/ Core Measure/National Safety Goals, Workers Compensation.

Special Requests: You must be able to complete labs within 48 hours of signing.

Shift & Scheduling: 4x10s or 5x8s. Every other Weekend

Floating Requirements: Units and to sister hospital, Palomar Health, Poway