Registered Nurse - Case Manager

Duties

• As a Case Manager, you will be responsible for managing patient care coordination and discharge planning in a fast-paced acute hospital environment.
• You will organize and participate in family meetings, develop treatment plans, and arrange DME, SNF, and ambulance transport independently.
• You will work with interdisciplinary support teams including IV Teams, Physical Therapy, Respiratory Services, and more.

Skills

• Care coordination
• Discharge Planning
• Utilization Review
• Admission Criteria
• Benefits Eligibility
• Plan of Care
• Prior Authorizations
• Utilize InterQual Criteria*
• HIPAA guidelines (Health Insurance Portability and Accountability Act)
• CMS: Centers for Medicare and Medicaid Services
• DRG (Diagnosis Related Groups)
• Computerized documentation

Experience

• 2 years of acute Hospital Case Manager experience
• Experience with Care Coordination and Discharge Planning
• Patient Ratio Experience: 1:20
• Charting System: Epic
• Travel Experience Required
• BLS Certification
• Preferred: Teaching Hospital Experience, Community Hospital Experience, LTAC Experience, Trauma Level I & II Experience
• Experience in various work settings such as Acute Hospital, Ambulatory Care, Behavioral Health, Home Health, Hospice, Insurance Company, Long Term Acute Care/Rehab/Skilled Nursing*
• Experience in specialties like Behavioral Health, Emergency Department, ICU, MS, NICU, Pediatrics, SDU/PCU/IMC/Obs*
• Experience with regulatory requirements including CPT coding and billing*, ICD 10 Coding*, NCQA*