Experience
- Minimum 2 years acute care experience required
- Previous travel experience required
- Experience with HMOs, IPAs, and advance directive processes required
- Must have current case management experience, within the last year
- Float required to meet department needs
License & Certification Required
- Valid RN license required; compact license must be in hand at submission
Skills Required
- Acute Hospital care coordination
- Admission criteria
- Appeals and denials management
- Benefits eligibility assessment
- CMS: Centers for Medicare and Medicaid Services knowledge
- Discharge planning
- DRG (Diagnosis Related Groups) knowledge
- HIPAA guidelines compliance
- ICU care experience
- Medical-Surgical care experience
- Needs assessment for DME (Durable Medical Equipment)
- Pediatrics experience
- Prior authorizations processing
- Knowledge of The Joint Commission/Core Measure/National Safety Goals
- Workers Compensation case management experience
Desired Skills
- Experience with pediatric populations
- Experience in protective services processes
