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
License & Certification Required
- Valid RN license in hand at submission
Skills Required
- Care coordination
- Discharge planning
- Admission criteria knowledge
- Appeals and denials management
- Benefits eligibility knowledge
- Prior authorizations management
- Knowledge of CMS regulations
- Understanding of HIPAA guidelines
- Experience with DRGs (Diagnosis Related Groups)
- Experience with pediatric and adult care
- Knowledge of The Joint Commission Core Measures
- Expertise in acute care hospital case management with current experience
Desired Skills
- Experience with interdisciplinary support services
