Travel Nurse RN - Case Manager - $2,362 per week in Torrance, CA

Job Title: Case Manager Profession: Nursing Specialty: Case Management Duration: 14 weeks Shift: 5x8.0 Hours per Shift: 8.0 Experience: Minimum of 2 years clinical experience; 2 years of Case Management experience or certification in Case Management License: Current RN license Certifications: Current BCLS certification Must-Have: Utilization Review experience Description: This position reports to the Director of Case Management. Accountability for the practice of nursing lies with the Senior Vice President of Patient Care Services. Performs chart reviews and quality assessments on all patients using Severity of Illness and Intensity of Service criteria as directed by Administration and the Medical Staff. Emphasis on the identification and implementation of Case Management interventions that have less predictable outcomes. Monitors activity of observation cases to ensure timely patient discharge. If not discharged appropriately, ensures the physician writes an order for inpatient services. Initiates Medi-Cal TARs at the time of admission or as soon as possible thereafter. Documents daily using Severity of Illness and Intensity of Service criteria. Evaluates the Case Management Plan in changing patient care situations for patients within the assigned work shift. Educates physicians and appropriate personnel regarding criteria for Utilization Management. Provides documentation for denial letters and delivers them to patients as directed by the Utilization Management physician advisor. Researches and prepares appeals for denial claims. Uses innovative problem-solving skills in dealing with complex patient and significant other situations. Identifies inappropriate bed utilization and quality of care problems and refers them to the Utilization Management physician advisor.