2-year acute medical RN Care Manager performing Care Coordination & Discharge Planning. Will not be doing Utilization Review
Profession: Registered Nurse
Specialty: Case Management
Location: Mission Viejo, CA
Facility: Acute Care Hospital
Job Type: Contract/Travel
Hourly Rate: $65
Shift: Day 5x8-Hour (08:00 - 16:30)
Duration: 13 weeks
Experience: 2 years of care coordination & discharge planning in acute care. Trauma I or II experience preferred.
License: CA RN
Certifications: BLS
First-timers accepted: No, requires travel experience
Weekend Req: Yes, Rotating
Float: Yes to the Laguna facility
Skills Required:
Work Settings
Acute Hospital - Behavioral Health*, Emergency Department*, ICU*, MS, NICU*, Pediatrics*, SDU/PCU/IMC/Obs*,
Ambulatory*
Behavioral Health*
Home Health*
Hospice*
Insurance Company*
Long Term Acute Care/Rehab/Skilled Nursing*
Case Management/Utilization Review
Admission Criteria
Benefits Eligibility
Care coordination
Data Abstraction*
Determine Medical Necessity per Evidence-Based Guidelines*
Disability case management*
Discharge Planning
Disease management*
Needs Assessment/ Order DME
Plan of Care
Prior Authorizations
Utilize InterQual Criteria*
Worker’s comp case management*
Regulatory
CMS: Centers for Medicare and Medicaid Services
CPT (Current Procedural Terminology) coding and billing*
Department of Health*
DRG (Diagnosis Related Groups)
HIPAA guidelines (Health Insurance Portability and Accountability Act)
ICD 10 Coding*
NCQA (National Committee for Quality Assurance)*
OSHA
The Joint Commission/ Core Measure/National Safety Goals
Workers Compensation*
Acute Hospital Experience by Specialty
Emergency Department*
ICU*
MS
Surgical Services*
Special Procedures/Unit Details: Experience with Assessing patients, Care Coordination, and Discharge Planning.
• Ability to organize and participate in family meetings.
• Participate in the development of the treatment plan.
• Experience with HMOs, IPAs, etc.
• Knowledge of adoption/foster care, drug/alcohol abuse treatment options, patients experiencing homelessness, patients with mental health history or in crisis, advance directive, POLST, protective services process, etc.
• Competent with arranging DME, SNF and ambulance transport. Must be able to perform this task independently.
Charting Experience Required: Epic preferred
Ratio: 1:20
