Experience
- Minimum 2 years acute care experience required
- Previous travel experience required
- Experience with HMOs, IPAs, advanced directives, and protective services processes required
- Must have current case management experience within the last year
- Experience with care coordination and discharge planning required
License & Certification Required
- Registered Nurse (RN) license required
Skills Required
- Knowledge of admission criteria
- Experience with appeals and denials
- Benefits eligibility knowledge
- Familiarity with CMS: Centers for Medicare and Medicaid Services
- Understanding of HIPAA guidelines
- Experience with Diagnosis Related Groups (DRG)
- Comfortable working with patients in ICU, MS, Pediatrics, and Geriatrics
- Skills in needs assessment and ordering durable medical equipment (DME)
- Experience with prior authorizations
- Knowledge of The Joint Commission, Core Measure, and National Safety Goals
- Experience with worker’s compensation case management
Desired Skills
- Knowledge of the Epic charting system preferred
- Experience in managing a patient ratio of 20
