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 and Experience: Work Settings

Acute Hospital Long Term Acute Care/Rehab/Skilled Nursing Case Management/Utilization Review

Admission Criteria Care coordination Discharge Planning Utilize InterQual Criteria Utilize Milliman Guidelines Utilization Review

Admission Criteria Appeals and Denials Concurrent Review Continued Stay Reviews Medical Necessity Retrospective Review Utilize InterQual Criteria Utilize Milliman Guidelines Regulatory

CMS: Centers for Medicare and Medicaid Services CPT (Current Procedural Terminology) coding and billing Department of Health DRG (Diagnosis Related Groups) HEDIS (The Healthcare Effectiveness Data and Information Set) Measures HIPAA guidelines (Health Insurance Portability and Accountability Act) ICD 10 Coding NCQA (National Committee for Quality Assurance) OSHA: Occupational Safety and Health Administration The Joint Commission/ Core Measure/National Safety Goals Worker’s Compensation

Required Credentials: Drivers License/State ID. BLS must be AHA, RQI, ARC, or American Safety and Health Institute

Shift & Scheduling Requirements: Traveler must work 2 out of 3 holidays if needed.

Special Request Requirements: If candidate resides in one of the restricted counties, they are not eligible for assignment. Restricted Counties-Delta, Franklin, Red River, Hopkins, Bowie, Morris, Titus, Cass, Camp, Rains, Upshur, Marion, Van Zandt, Smith, Gregg, Harrison, Henderson, Anderson, Cherokee, Rusk, and Panola. References must cover at least 1 full year of relevant experience in specialty within the past 3 years.