Experience
- Minimum 2 years acute care experience required
- Previous travel experience required
- Must have current experience in Case Management within the last year
- Experience with HMOs, IPAs, etc. required
- Experience with advance directives, POLST, and protective services process required
- Float required to meet department needs
License & Certification Required
- Valid State License (Compact license must be in hand at submission)
Skills Required
- Admission Criteria
- Appeals and Denials
- Benefits Eligibility
- Care coordination
- CMS: Centers for Medicare and Medicaid Services
- Discharge Planning
- DRG (Diagnosis Related Groups)
- Emergency Department experience
- HIPAA guidelines (Health Insurance Portability and Accountability Act)
- ICU experience
- MS experience
- Needs Assessment/Order DME
- Pediatrics experience
- Prior Authorizations
- SDU/PCU/IMC/Obs experience
- The Joint Commission/Core Measure/National Safety Goals experience
- Workers Compensation case management experience
Desired Skills
