What are the responsibilities and job description for the Case Management Nurse position at HumanEdge?
Opportunity Description
Looking for your next adventure as a Travel RN or Allied Health Professional? We’re here to help you make the perfect match! With over 30 years of experience, our full-service staffing firm specializes in connecting talented healthcare professionals with exciting travel opportunities across the country.
Company Information
Looking for your next adventure as a Travel RN or Allied Health Professional? We’re here to help you make the perfect match! With over 30 years of experience, our full-service staffing firm specializes in connecting talented healthcare professionals with exciting travel opportunities across the country.
Job Duties
- Completes a comprehensive initial assessment.
- Performs all activities for multidisciplinary care coordination at the intra-hospital level of care and inter-hospital level of care.
- Performs all transitional planning activities
- Ensures department goals of LOS reduction, readmission prevention, denial reduction, and satisfaction improvement are realized.
- Performs all UR activities per department policy:
- Commercial payer reviews
- Disposition determination
- Retro/self-audit
- MC variance
- Admission clinical review.
Experience & Skills Required
- DISCHARGE EXPERIENCE REQUIRED
- Registered Nurse (RN) NYS license required
- PRI Certification
- Screen certification strongly preferred
- Care Management certification preferred (i.e. CMC, CCM etc.)
- 3 years clinical ED, critical care or med/surg experience preferred
- Previous case management experience preferred
- Knowledge of healthcare financial, regulatory, and payer issues preferred
- Knowledge of state, local, and federal programs strongly preferred
- Experience in use of Milliman/InterQual criteria
Benefits
- Excellent pay tailored to your needs
- Referral bonus program
- Weekly direct deposit
- Comprehensive benefits package
- Low-cost Medical, Dental and Vision insurance
- Travel reimbursement
- 401K options
- 24/7 support before, during and after your assignment
- CEU reimbursements
- Licensure reimbursement
Salary : $70 - $75
