Travel Nurse RN - Case Manager - $2,815 per week in Irvine, CA
TravelNurseSource
Irvine, CA
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JOB DETAILS
SALARY
$2,815–$2,815
SKILLS
Acute Care, Basic Life Support (BLS), Cancer, Case Management, Certified Case Manager (CCM), Content Management Systems (CMS), Current Procedural Terminology (CPT), Diagnosis-Related Group (DRG), Discharge Plans, Documentation, HIPAA (Health Insurance Portability and Accountability Act), Healthcare Effectiveness Data and Information Set (HEDIS), ICD-10, Long-Term Care, National Committee for Quality Assurance (NCQA), Patient Care Denials, Registered Nurse (RN), Utilization Management
LOCATION
Irvine, CA
POSTED
Today
Job Title: Case Manager Utilization Review RN Profession: Registered Nurse Specialty: Case Manager Duration: 13 weeks Shift: Day Hours per Shift: 8 Experience: 5 years required License: State License required Certifications: BLS, BSN required Must-Have: - Epic documentation experience - InterQual documentation experience - Acute care experience - Long-term acute care or skilled nursing experience Description: Case Manager and Utilization Review RN for cancer specialty. Five years of experience required. Responsibilities include utilizing InterQual criteria for admission and continued stay reviews. Must adhere to SBAR communication standards. Weekends are required. Knowledge of UR admission criteria, appeals and denials, and medical necessity is essential. Experience in care coordination and discharge planning is necessary. Familiarity with CMS guidelines, CPT coding and billing, and DRG is required. Understanding of HEDIS measures and HIPAA guidelines is important. Proficiency in ICD-10 coding is essential. Compliance with OSHA and The Joint Commission standards is expected. Candidate must possess knowledge of NCQA standards.
About the Company
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