Experience
- Minimum 2 years acute care experience required
- Previous travel experience required
- Experience with HMOs, IPAs, and advance directives
- Experience within the last year in acute care hospital case management
License & Certification Required
- Valid RN 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
- 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
- Worker’s comp case management
- Workers Compensation experience
Desired Skills
- Experience with protective services process
