Experience
- Minimum 2 years acute care experience required
- Previous travel experience required
- Experience with HMOs, IPAs, and advance directives required
- Experience with protective services process required
- Experience in case management needed
- Must have current case management experience within the last year
License & Certification Required
- Registered Nurse (RN) license required
- Compact license must be in hand at submission
Skills Required
- Care coordination
- Discharge planning
- Prior authorizations
- Understanding of CMS (Centers for Medicare and Medicaid Services) guidelines
- Knowledge of HIPAA guidelines (Health Insurance Portability and Accountability Act)
- Familiarity with DRG (Diagnosis Related Groups)
- Experience with admission criteria
- Knowledge of appeals and denials
- Experience with pediatric and geriatric patient populations
- Experience in ICU and MS environments
- Experience with SDU/PCU/IMC/Obs
- Understanding of The Joint Commission/Core Measure/National Safety Goals
Desired Skills
- Experience with social services support
- Experience in worker's compensation case management
