Registered Nurse/Case Manager

IMCS Group Inc

Irvine, CA

JOB DETAILS
SKILLS
Billing, Cancer, Case Management, Centers for Medicare and Medicaid Services (CMS), Certified Case Manager (CCM), Current Procedural Terminology (CPT), Diagnosis-Related Group (DRG), Discharge Plans, Health Department, Healthcare Effectiveness Data and Information Set (HEDIS), Hospital, National Committee for Quality Assurance (NCQA), OSHA, Patient Care, Registered Nurse (RN), Utilization Management
LOCATION
Irvine, CA
POSTED
10 days ago
Complex inpatient Case Manager and Utilization Review RN for Cancer Specialty Hospital. 6/16 start. 5 years' experience in specialty required. Epic & InterQual documentation; SBAR communication. Rotating weekends required.

Certifications REQUIRED: BLS; BSN; State License

Skills/Experience REQUIRED: Acute Hospital; Long Term Acute Care/Rehab/Skilled Nursing; Admission Criteria; Care Coordination; Discharge Planning; Utilize InterQual Criteria; Utilize Milliman Guidelines; UR Admission Criteria; UR Appeals and Denials; UR Concurrent Review; UR Continued Stay Reviews; UR Medical Necessity; UR Retrospective Review; UR Utilize InterQual Criteria; UR Utilize Milliman Guidelines; CMS: Centers for Medicare and Medicaid Services; CPT (Current Procedural Terminology) coding and billing; Department of Health; DRG (Diagnosis Related Groups); HEDIS (The Healthcare Effectiveness Data and Information Set) Measures; HIPAA guidelines (Health Insurance Portability and Accountability Act); ICD 10 Coding; NCQA (National Committee for Quality Assurance); OSHA; The Joint Commission/ Core Measure/National Safety Goals
Workers Compensation

About the Company

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IMCS Group Inc