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, Inpatient CM experience, Community Hospital Experience

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

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

Skills: Ambulatory care, Behavioral Health, Home Health, Hospice, Insurance Company experience, Long Term Acute Care/Rehab/Skilled Nursing, Telephonic case management, Specialty Acute Experience (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 coding and billing, Quality Improvement, Department of Health regulations, HEDIS Measures, ICD-10 Coding, NCQA standards, OSHA, and The Joint Commission Core Measures/National Patient Safety Goals.

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

Shift & Scheduling: Every other weekend

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